Considering the growing evidence supporting a role of low-grade inflammation in OA pathogenesis, the results of this study suggest a role for calcium crystals in the development of the disease.īasic calcium phosphate crystals Calcium pyrophosphate crystals Inflammation Power Doppler Scanning electron microscopy Synovial fluid. No association between the presence of crystals and the radiographic scores has been observed. The prevalence of BCP crystals alone was, instead, higher in the early (23%) with respect to the late group (19.4%). Classifying our patients according the severity Kellgre-Lawrence score, we found that the prevalence of CPP alone (27.8%) or in combination with BCP (11.1%) was higher in the late stage group with respect to the early one (CPP 21.6% and CPP + BCP 4.1%, respectively). ![]() Categorizing patients according to SF crystal type, a strong association between BCP crystal presence, and higher WOMAC and Lequesne index scores has been uncovered. SEM analyses uncovered CPP crystals in 26 patients (23.6%), BCP crystals in 24 patients (21.8%), and both types of crystals in 7 patients (6.3%). Scanning electron microscopy (SEM) was used to detect SF crystals. One-hundred-and-ten patients with knee OA completed the Western Ontario and McMaster Universities Arthritis Index (WOMAC) self-assessment questionnaire, the Lequesne algofunctional index survey, and the visual analogic scale forms they also underwent power Doppler ultrasonography (PDUS) to assess synovial inflammation. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.The current study aimed to investigate the association of calcium pyrophosphate (CPP) and basic calcium phosphate (BCP) crystals in synovial fluid (SF) of patients with osteoarthritis (OA) with disease severity, clinical symptoms, and synovial inflammation. This information is provided for general education only. Updated February 2023 by Mohammad Ursani, MD, and reviewed by the American College of Rheumatology Committee on Communications and Marketing. These health care providers guide therapy to improve flexibility, ease joint pain and adapt movements for better function. Rheumatologists may refer some people with CPPD to physical and occupational therapists. See a rheumatologist as soon as symptoms appear to rule out other possible causes and start treatment. Prompt diagnosis and treatment of CPPD may ease symptoms and prevent joint damage. Surgery may be used to repair or replace damaged joints. For severe attacks or chronic inflammation, drugs like methotrexate) or the interleukin beta-1 antagonist anakinra (Kineret) are treatment options. colchicine or low dose NSAIDs can be used to prevent future attacks. The rheumatology provider may drain fluid from the affected joint and inject a corticosteroid. Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to treat joint pain and swelling in an acute CPPD event.There is no treatment to dissolve the crystals. MRI, ultrasound, CT scan or X-ray may show calcium containing deposits in cartilage. Additionally, the rheumatology provider may need to withdraw fluid from a joint to make the diagnosis of CPPD. A rheumatologist diagnoses CPPD based on symptoms and medical tests. Joint cartilage may break down, causing disability. If left untreated, CPPD may lead to severe, painful attacks and chronic joint inflammation. It occurs when calcium pyrophosphate crystals sit in the joint and surrounding tissues and cause symptoms like gout. Knees are the joints most commonly affected, but CPPD can other joints. What Are the Signs/Symptoms?ĬPPD symptoms include severe joint pain, warmth and swelling. CPP crystals may also be found in the joints of people with osteoarthritis or gout. Excess iron or calcium, or low magnesium, and an abnormal thyroid gland may be contributing factors. ![]() The white cell count, differential count, cultures, Gram stain, and crystal search using polarized light microscopy are the most useful studies. Crystal deposits trigger an inflammatory attack in the joint. Synovial fluid analysis is helpful for determining the underlying cause of arthritis, particularly for septic or crystal-induced arthritis. People over 60 are more likely to get CPPD, although it may happen at an earlier age. In CPPD, calcium pyrophosphate (CPP) crystals form in the blood and settle in joint cartilage. Calcium pyrophosphate deposition (CPPD)also known as “pseudogout” is a type of arthritis.
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