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Abstract
Arthropathy induced by monosodium salt of uric acid [C5H4N4O3] (MSU) (gout), by calcium pyrophosphate dihydrate [Ca2P2O7.2H<sub>2</sub>O] (CPPD) crystals (chondrocalcinosis, pseudogout, pyrophosphate arthropathy) and arthropathy induced by hydroxyapatite [Ca5(PO<sub>4</sub>)3(OH)] (HA) crystals (apatite rheumatism, hydroxyapatite arthritis, calcifying tenosynovitis, Milwaukee syndrome, calcific tendinitis, calcific periarthritis) are regarded as distinct clinical entities.
Highlights
Metabolic diseases and crystal induced arthropathies are characterized by deposits of crystal and/ or non-crystalline calcium phosphates in synovial membranes and periarticular soft tissues
Arthropathy induced by monosodium salt of uric acid [C5H4N4O3] (MSU), by calcium pyrophosphate dihydrate [Ca2P2O7.2H2O] (CPPD) crystals and arthropathy induced by hydroxyapatite [Ca5(PO4)3(OH)] (HA) crystals are regarded as distinct clinical entities [4,5,6,7,8,9,10,11,12,13,14]
The aim of this study was to compare the “non-staining” technique according to Bély and Apáthy (2013) [22] with worldwide accepted stains and histochemical methods such as hematoxylin-eosin (H-E) staining, Gömöri’s methenamine silver method, Schultz staining, Alizarin red S staining, and von Kossa’s reaction [17,18,19,20,21] in tissue samples of patients with clinically diagnosed gout, chondrocalcinosis and apatite rheumatism in order to demonstrate the effectivity of crystal detection with these standard methods in comparison with non-staining technique [22]
Summary
Metabolic diseases and crystal induced arthropathies are characterized by deposits of crystal and/ or non-crystalline (amorphous) calcium phosphates in synovial membranes (synovium) and periarticular soft tissues. Bone and cartilage may be involved, and crystals may be present in the synovial fluid as well. Foreign bodies and refractile artefacts may vary the histopathological findings. Different crystals (with or without foreign bodies and/or refractile artefacts) may exist simultaneously in synovial fluid, synovium or adjacent bone and cartilage. Arthropathy induced by monosodium salt of uric acid [C5H4N4O3] (MSU) (gout), by calcium pyrophosphate dihydrate [Ca2P2O7.2H2O] (CPPD) crystals (chondrocalcinosis, pseudogout, pyrophosphate arthropathy) and arthropathy induced by hydroxyapatite [Ca5(PO4)3(OH)] (HA) crystals (apatite rheumatism, hydroxyapatite arthritis, calcifying tenosynovitis, Milwaukee syndrome, calcific tendinitis, calcific periarthritis) are regarded as distinct clinical entities [4,5,6,7,8,9,10,11,12,13,14]
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