Abstract
Calcium pyrophosphate dihydrate and basic calcium phosphate crystals are commonly found in patients with calcium deposition diseases. Deposits of these crystals are common in the elderly and they have been implicated in the pathogenesis of osteoarthritis. The presence of crystal deposits is often asymptomatic, although it can be intermittently symptomatic and elicit acute and chronic arthritis. Acute intra- and peri-articular inflammation are clinically similar to cellulitis, gout and septic arthritis. Plain radiography of the affected joints is usually the first and most valuable diagnostic method to evaluate these conditions. Ultrasonography is highly sensitive for the detection of crystals in the synovial fluid and of crystals deposited in cartilage and soft tissue. Joint-fluid analysis is far more sensitive than radiologic study to detect calcium pyrophosphate dihydrate and basic calcium phosphate crystal deposits, and arthrocentesis is indicated in some patients to rule out septic arthritis.
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