Basic calcium phosphate and calcium oxalate Kristallarthropathien show similar clinical manifestations as the other crystal-induced arthritis. Dibasic calcium phosphate form of crystal Most pathological calcium deposits in the body contain a mixture of hydroxyapatite and octacalcium phosphate. Because these crystals are ultramicroscopic nichtazide calcium phosphates, the term basic calcium phosphate (BCP) is much more precise than apatite. These ultramicroscopic crystals occur in snowball-like clumps in rheumatic diseases (eg. As calcifying periarthritis, some cases of progressive systemic sclerosis and dermatomyositis) on. You can be found with osteoarthritis in the joint fluid and cartilage in patients that is so advanced that strikes a joint space in the X-ray findings. BCP crystals can lead to joint destruction and cause severe intra-articular or periarticular inflammation. The Milwaukee shoulder syndrome, a pronounced destructive arthropathy especially in older women, the (often) occur in the shoulders and in the knee joints, is an example. Acute gout due to periarticular BCP deposits can mimic gout. This occurs as a discrete clinical syndrome in young women (less common in young men) and is just as acute gouty arthritis treated. In addition to the synovial fluid, a radiograph of symptomatic joints should be made. On the X-ray image BCP crystals can be periarticular visible as a cloud-like cloudy; the crystals often resolve spontaneously au months or sometimes within days. A definitive test for detecting BCP crystals in synovial fluid is not yet possible. Clumped crystals can be identified only by a transmission electron microscope. The clumps are not birefringent under polarized light. Treatment with oral colchicine, NSAIDs, or if a large joint is affected, with intra-articular corticosteroids is helpful. The treatment is the same as for acute gout. Calcium oxalate form of crystal calcium oxalate A form of crystal is rare. It occurs mostly in azotemic patients receiving hemodialysis or peritoneal dialysis, v. a. in patients with ascorbic acid (vitamin C) are treated, which is metabolized to oxalate. The crystals can be deposited in the vessel walls, in the skin and in joints. The crystals appear as birefringent bipyramidal structures. In the synovial fluid, there are up to 2,000 leukocytes / ul. Radiographically calcium oxalate are indistinguishable from BCP periarticular or Kalziumpyrophosphatdihydrat (CPPD) -Kristallablagerungen in cartilage. The treatment is that of the CPPD form of crystal.


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