crystals in synovial fluid
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Indications
- monosodium urate crystals
- 3-20 um long
- within neutrophils, distending neutrophil cytoplasm
- strongly negatively birefringent crystals
- with 1st order red compensator, crystals are yellow when parallel to the orienting line & blue when perpendicular
- associated clinical disorders:
- calcium pyrophosphate dihydrate (CPPD) crystals
- hydroxyapatite crystals
- small, needle-shaped crystals < 1 um long & 7.5-25 nm in diameter
- too small to be seen by light microscopy
- electron microscopy needed for identification
- aggregated lumps
- may be birefringent
- staining with alizarin red S[3]
- not important for diagnosis, prognosis or guidance in treatment
- calcium oxalate dihydrate crystals
- bipyramdal envelopes, 5-30 um in diameter
- variable birefringence with elongation
- associated clinical disorders:
- arthropathies associated with renal dialysis
- primary oxalosis (rare inborn error of metabolism)
- lipid crystals
- spheres 1-20 um in diameter
- maltese cross appearance with positive birefringence under compenstated polarized light
- associated clinical disorders: acute arthritis
- cholesterol crystals
- corticosteroid crystals
- may be positively or negatively birefringent
- pleomorphic
- generally from intra-articular steroid injections
- lithium heparin crystals (positively birefringent)
- starch or glove powder
- round, strongly birefringent, 5-30 um in diameter
- may appear as maltese cross under polarized light
- may be introduced during joint surgery
- other crystals or particulate matter found in synovial fluid
- immunoglobulins
- Charcot-Leyden crystals
- amyloid fragments
- cartilage fragments
- collagen fibrils
- fibrin strands
- hematoidin crystals from previous hemorrhage
- crystals from anticoagulants
- nail polish
- prosthetic fragments
- dust particles
More general terms
More specific terms
Additional terms
References
- ↑ Laboratory Medicine: Test Selection & Interpretation. Howanitz & Howanitz (eds), Churchill Livingstone, NY, 1991, pg 119-121
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 469-470
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998