Abstract
This exhibit is intended to portray the central role that crystals play in two common "metabolic" arthritides, classic gout and chondrocalcinosis articularis<sup>1</sup>(pseudogout syndrome<sup>2</sup>). In this discussion we will reverse the usual order of presentation and cover the clinical features last. <h3>Diagnosis by Crystal Identification</h3> The differential diagnosis of arthritis is greatly aided by the gross and microscopic examination of synovial fluid (synovianalysis<sup>3</sup>). Crystals of sodium urate and calcium pyrophosphate are best seen in "wet" preparations of freshly aspirated synovial fluid. A drop of fluid is applied to a clean glass slide and overlaid<i>immediately</i>with a clean coverslip, the edges of which are sealed<i>immediately</i>with clear fingernail polish. Dried smears of fluid are difficult to inspect; centrifugation of the fluid before examination is<i>not</i>recommended. Compensated polarized light and phase contrast microscopy (magnification × 1,250) are simultaneously used in our laboratory; sodium urate crystals show
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