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Results for “Calcium Pyrophosphate”

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At least 577 records · Page 32Linked to original sources

PubMed1988

Acute pseudogout mimicking septic arthritis following urologic manipulation.

An 80-year-old man presented with an acute, rapidly worsening synovitis with a hot effusion of the right knee approximately 48 hours following a urologic procedure. Initial aspirates failed to reveal crystals and suggested an acute infectious arthritis. Because his course continued to deteriorate despite adequate antibiotic treatment, the patient underwent arthroscopy in order to place tubes and to effect adequate irrigation and debridement. The preoperative diagnosis was septic arthritis. At the time of arthroscopy, there was gross evidence of crystals that were subsequently diagnosed as calcium pyrophosphate. This case illustrates the importance of an adequate differential diagnosis and the usefulness of the arthroscope in obtaining adequate tissue and aspirate under confusing circumstances.

Aged↗

PubMed1977

The identification of particulate matter in biological tissues and fluids.

Sections, 1-2 micron thick, of Araldite embedded tissue were prepared to provide a link between optical and electron microscopy for the identification of crystals. This technique permits examination of individual particles by means of polarising light microscopy, electron microscopy, X-ray energy spectroscopy and electron diffraction. It provides a reliable method for routine and research studies. It has led to the positive identification of individual crystals of calcium pyrophosphate dihydrate and hydroxyapatite in synovial fluids. The method can be applied to the identification of other particulate matter in a variety of biological specimens.

Aged↗

PubMed1993

Pseudogout provoked by pregnancy.

Four women with chondrocalcinosis are described. Each developed acute attacks of synovitis during pregnancy (confirmed pseudogout, two; presumptive pseudogout, two). All patients had recognized predisposing factors (metabolic, familial, traumatic) for premature calcium pyrophosphate deposition, and in three this was their first episode of synovitis. This first report of provocation of pseudogout by pregnancy is of interest in respect of putative mechanisms of crystal shedding.

Adult↗

PubMed1997

Tophaceous pseudogout of the temporomandibular joint: report of a case.

An 85-year-old man was found to have a calcified mass protruding from the joint space of the right temporomandibular joint (TMJ). Microscopically, the removed mass consisted of chondromyxoid tissue with atypical chondrocytes, resembling a cartilaginous tumor. However, the chondromyxoid tissue contained abundant deposits of rod-shaped to rhomboid crystals which proved to be calcium pyrophosphate dihydrate (CPPD) crystals. The review of the literature revealed that tophaceous pseudogout was the most common variant of CPPD deposition disease involving the TMJ.

Aged↗

PubMed1985

Multiple microcrystal deposition within a family.

A family is described in which four members in three generations showed evidence of crystal deposition disease: two developed calcium pyrophosphate dihydrate (CPPD) crystal deposition, one calcific periarthritis, and one mixed crystal deposition disease (gout + chondrocalcinosis). This previously undescribed observation supports a possible role for nonspecific heritable connective tissue factors in predisposing to crystal deposition.

Adult↗

PubMed2006

CPPD complicating other forms of inflammatory arthritis.

Calcium pyrophosphate deposition (CPPD) disease is confirmed as equally common in rheumatoid arthritis by synovial fluid and macroscopic skeletal examination. Furthermore, differential frequencies in rheumatoid arthritis and spondyloarthropathy provide additional insights to the "lumper-splitter" question.

Arthritis, Rheumatoid↗

PubMed1984

Human articular cartilage and fibrocartilage: a study with high-angle x-ray diffraction.

High-angle x-ray diffraction was applied to the study of four meniscal fibrocartilages and 11 articular cartilages from patients suffering from various articular disorders. In eight samples microcrystals were seen, apatite most frequently, CaHPO4 in two instances, calcium pyrophosphate dihydrate (CPPD) in one. These results confirm the association of various crystals in a single joint, and favour their heterogenous partition on collagen fibres.

Adult↗

PubMed1992

[Calcinosis of the temporomandibular joint: apropos of a case and critical review of the literature].

We report a case of calcinosis of the temporo-mandibular joint. This microcrystalline arthropathy by deposits of calcium pyrophosphate crystals is exceptional at this level; it is necessary to look for other localizations joints to diagnose articular chondrocalcinosis. The local prognosis is the same with surgical treatment in case of articular destruction or significant deposits.

Calcium Pyrophosphate↗

PubMed2006

[Search for crystals in synovial fluid].

Synovial fluid analysis is a very important diagnostic procedure in rheumatology. Cell count allows the differentiation ting between inflammatory arthritis, in which cell count exceeds 2000 cells/mm3, and non inflammatory arthropathy, in which cell count is less than 1000 cells/mm3. Demonstration of crystals in synovial fluid is a rapid and inexpensive way to diagnose microcrystalline arthritis. Synovial fluid must be examined under normal and polarized light. Monosodium urate crystals are negatively birefringent, whereas calcium pyrophosphate dihydrate crystals are positively birefringent. Other crystals (cholesterol, oxalate, corticosteroids....) can also be identified in synovial fluid. Various artefacts must be avoided including anticoagulant crystals and synovial fluid must be anticoagulated with sodium heparin or citrate.

Calcium Oxalate↗

PubMed1980

[Purification and physico-chemical characteristics of chorionic alpha1-microglobulin].

Highly purified chorionic alpha-microglobulin was isolated from amniotic fluid by precipitation with lantham chloride, ammonium and lithium sulfates coupled with adsorption chromatography with calcium pyrophosphate. The following physicochemical properties of the protein were determined: molecular weight, relative electrophoretic mobility, interaction with protamine sulfate and lectins, enzymatic stability and precipitation with salts.

Alpha-Globulins↗

PubMed1981

Clinical and roentgenographic aspects of pseudogout: a study of 50 cases and a review.

Pseudogout, defined as recurrent acute arthritis due to intrasynovial deposition of calcium pyrophosphate dihydrate crystals, is a relatively common arthritic disorder of the elderly. The clinical and roentgenographic aspects of 50 cases of pseudogout in hospitalized patients are reviewed in this paper. Oligoarticular and polyarticular episodes were observed in half of these patients. Antecedent problems included infection, trauma, surgery and vascular events. Consistent with previous reports, most patients had roentgenographic evidence of chondrocalcinosis. A third had asymptomatic capsular or periarticular calcific deposits or both, and a third had pyrophosphate arthropathy, a progressive, destructive, accelerated form of osteoarthritis. An attack of pseudogout may offer a clue to the presence of an unsuspected metabolic disease, such as primary hyperparathyroidism or idiopathic hemochromatosis.

Age Factors↗

PubMed1994

Crystals in equine articular cartilage.

Crystal deposits have been observed in equine articular cartilage and identified by scanning electron microscopy and X-ray diffraction as octacalcium phosphate and calcium pyrophosphate dihydrate. Of 89 equine fetlock joints examined 10 contained evidence of calcification visible by eye. It is suggested that the deposition of crystals may be a mediator of arthritis in horses and may also cause damage directly.

Animals↗

PubMed2006

Photobiomodulation of pain and inflammation in microcrystalline arthropathies: experimental and clinical results.

OBJECTIVE: This article presents the results of laser therapy in crystal (hydroxyapatite, calcium pyrophosphate, and urates) deposition-induced arthritis in rats and the clinical applications in humans. BACKGROUND DATA: Microcrystalline arthropathies are prevalent among geriatric patients, who are more vulnerable to the side effects of drugs. The effectiveness of laser therapy for pain relief, free of side effects, has been reported in painful conditions. METHODS: Two milligrams of each of the above-mentioned crystals was injected in both joints of the back limbs in three groups of rats; these groups were then treated with laser irradiation. Three other groups received no treatment after the injections. We determined the plasmatic levels of inflammatory markers (fibrinogen, prostaglandin E2, and TNF(alpha)), tissues (prostaglandin E(2)) and conducted anatomopathological studies. Twenty-five patients with acute gout arthritis were randomized into two groups and treated over 5 days: group A, diclofenac 75 mg orally, twice a day; and group B, laser irradiation once a day. Forty-nine patients with knee chronic pyrophosphate arthropathy were randomized into two groups and treated over 21 days; group A, diclofenac 50 mg orally, twice a day; and group B, laser irradiation once a day. Thirty patients with shoulder chronic hydroxyapatite arthropathy were randomized into two groups and treated over 21 days; group A, diclofenac 50 mg orally, twice a day; and group B, laser irradiation once a day. RESULTS: Fibrinogen, prostaglandin E(2), and TNF(alpha) concentrations in the rats injected with crystals and treated with laser decreased significantly as compared with the groups injected with crystals without treatment. Both laser therapy and diclofenac achieved rapid pain relief in patients with acute gouty arthritis without significant differences in efficacy. Laser therapy was more effective than diclofenac in patients with chronic pyrophosphate arthropathy and in patients with chronic apatite deposition disease. CONCLUSION: Laser therapy represents an effective treatment in the therapeutic arsenal of microcrystalline arthropathies.

Animals↗

PubMed2001

Evaluation of crystals in formalin-fixed, paraffin-embedded tissue sections for the differential diagnosis of pseudogout, gout, and tumoral calcinosis.

Hematoxylin-eosin (H&E)-stained sections may not allow proper evaluation of birefringence properties of the crystals in the lesions of pseudogout, gout, and tumoral calcinosis. This study was undertaken to verify the application of a special stain that could facilitate the evaluation of the birefringence properties of these crystals for definitive diagnosis. We evaluated previously described nonaqueous alcoholic eosin staining (NAES) method based on the principle of using alcoholic eosin without hematoxylin and any other aqueous reagents for staining of formalin-fixed, paraffin-embedded tissue sections. Two observers, in a blinded fashion, evaluated the sections stained with routine H&E and NEAS method without the knowledge about clinical diagnosis. All pseudogout (nine sections from seven cases) and gout (eight sections from five cases) lesions demonstrated birefringence in the sections stained with NAES method. H&E-stained sections showing the respective diagnostic histomorphology failed to demonstrate the birefringent crystals by polarizing microscopy in all the eight sections from gout and in seven of nine sections from pseudogout. Only two H&E-stained sections showed scant calcium pyrophosphate dihydrate (CPPD) crystals in pseudogout. None of the three sections from two cases of tumoral calcinosis showed birefringence with either stain. We conclude that CPPD in pseudogout and monosodium urate in gout may not polarize in the routine H&E-stained sections. However, polarizing microscopy of sections stained with NAES method allowed demonstration of CPPD crystals with positive birefringence in pseudogout, MSU crystals with negative birefringence in gout, and calcium hydroxyapatite crystals without birefringence in tumoral calcinosis. Section stained with NAES method is a significantly useful adjunct to the routine H&E stain for proper evaluation of the crystals under polarizing microscope in these lesions.

Calcinosis↗

PubMed1999

Destructive tophaceous calcium hydroxyapatite tumor of the infratemporal fossa. Case report and review of the literature.

Tophaceous pseudogout is one of the rarest forms of crystal deposition disease, typically presenting as a destructive and invasive mass involving the temporomandibular joint or the infratemporal fossa region in the absence of any other articular manifestations. Previous cases have been assumed to be caused by calcium pyrophosphate dihydrate (CPPD) crystal deposition, based on finding weakly birefringent crystals in the involved tissues. The authors present the unique case of a 65-year-old woman with a destructive and invasive facial mass extending to the middle cranial fossa with microscopic and clinical features consistent with tophaceous pseudogout. High-resolution x-ray crystallographic powder diffraction and Fourier transformed infrared spectroscopy subsequently revealed that the crystals were composed of calcium hydroxyapatite without CPPD. The patient was later found to have primary hyperparathyroidism and mild hypercalcemia. This case demonstrates that tissue deposits of calcium hydroxyapatite can cause a destructive and invasive mass containing weakly birefringent crystals and raises the question of whether previous cases attributed to tophaceous pseudogout resulting from CPPD actually were composed of birefringent calcium hydroxyapatite.

Aged↗

PubMed1984

Hypomagnesemia with chondrocalcinosis.

Two patients are described with calcium pyrophosphate crystal deposition and hypomagnesemia. There appears to be a meaningful association between the two findings, although the precise mechanism explaining this association is not clear. The identification of chondrocalcinosis on radiographs may be an important clue to the presence of hypomagnesemia.

Adult↗

PubMed1980

Intervertebral chondrocalcinosis: A coincidental finding possibly related to previous surgery.

Chondrocalcinosis of the intervertebral discs is a common finding in patients who have had prior surgical procedures involving the same or adjacent disc space. The crystals in the tissues have the characteristic morphologic and spectrophotometric features of calcium pyrophosphate dihydrate. None of the patients described herein had clinical or radiographic evidence of crystal accumulation in sites remote from the surgical procedure. We propose that the surgical trauma may have played a role in the induction of the crystal deposits.

Adolescent↗

PubMed1999

Myelopathy due to calcification of the cervical ligamenta flava: a report of two cases in West Indian patients.

Two cases of cervical myelopathy due to calcification of the ligamenta flava (CLF) are described for the first time in black patients from the French West Indies. A pre-operative CT scan differentiated the diagnosis from one of ossification of the ligamenta flava. Microanalysis on the operatively excised specimen in one patient revealed a mixture of calcium pyrophosphate dihydrate crystals and hydroxypatite crystals. Poor outcome in one patient contrasting with excellent recovery in the other one, who had undergone posterior decompressive laminectomy, emphasizes the importance of surgery in the management of CLF.

Aged↗