Deposition of crystals has been identified as a cause of arthritis. With increasing diagnostic capabilities being achieved we are able to look at and identify crystals better now. Study of crystal identification involves aspiration of synovial fluid and analyzing it for crystal examination.
Various tools that are used to identify and analyse contents in synovial fluids are
- Gross Examination
- Microscopic examination including electron microscopy
- Energy dispersive elemental analysis
X-ray diffraction have established the role of different microcrystals including monosodium urate , calcium pyrophosphate dehydrate (calcium pyrophosphate dihydrate), calcium hydroxyapatite , and calcium oxalate, in inducing arthritis.
Each of these crystals may cause acute or chronic arthritis or periarthritis.
In spite of differences in crystal morphology, chemistry, and physical properties, the clinical events that result from deposition and release of monosodium urate, calcium pyrophosphate dihydrate, and calcium oxalate are usually not differentiable
In the setting of acute articular or periarticular inflammation, aspiration of synovial fluid analysis is done to distinguish possibilty of infection and to identify the type of crystals present.
Apart from the identification of specific microcrystalline materials or organisms, synovial fluid characteristics are nonspecific, and synovial fluid can be inflammatory or noninflammatory.
The presence of crystals does not exclude the existence of an associated acute or chronic infection.
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