pyrophosphate and Rheumatic-Diseases

Topics: Arthrography; Chondrocalcinosis; Diphosphates; Global Health; Gout; Humans; Pedigree; Rheumatic Diseases

The basic principles of the determination of crystals in synovial fluid by means of the polarisation microscope are described. The presence of crystals in synovial fluid was determined in 48 patients with the following clinical diagnoses: rheumatoid arthritis, gout, pseudogout, reactive arthritis, in patients with a diagnosis of extraarticular rheumatism: peritendinitis, in patients with reactive arthritis and in 2 patients with injured knee joint. Crystals of Na urate, Ca-pyrophosphate dihydrate and cholesterol were found. The analysis of synovial fluid for the presence of crystals in an important diagnostic procedure contributing greatly to the quick and correct diagnosis of arthritis.

Topics: Cholesterol; Crystallization; Diphosphates; Female; Humans; Knee Injuries; Male; Rheumatic Diseases; Synovial Fluid; Uric Acid

The synovial fluid ferritin level in 49 patients (57 joints) with various rheumatic diseases was analysed. In rheumatoid arthritis (n = 22) the geometric mean ferritin level was 528 micrograms/l (range 56-3 100 micrograms/l), in other inflammatory arthritides (n = 12) 339 micrograms/l (105-2 835 micrograms/l) (p greater than 0.5), in calcium pyrophosphate arthropathy (n = 14) 507 micrograms/l (180-4 230 micrograms/l) (p greater than 0.5) and in non-inflammatory osteoarthritis (n = 9) 167 micrograms/l (14-725 micrograms/l) (p less than 0.05). Synovial fluid/serum ferritin ratios did not differ significantly in the four diagnostic groups; 4 patients had ratios less than 1.0. Synovial fluid ferritin was not correlated to total fluid cell count or differential cell count. Although ferritin content was significantly greater in inflammatory than in noninflammatory fluid (p less than 0.05), the wide scatter of the values and marked overlap between the different groups limit the value of measuring synovial fluid ferritin as a differential diagnostic test for rheumatic diseases.

Topics: Arthritis, Rheumatoid; Diphosphates; Female; Ferritins; Humans; Male; Osteoarthritis; Rheumatic Diseases; Synovial Fluid

Scintigraphic exploration of the sacroiliac (S.I.) joints by 99 m-technetium pyrophosphate is simple and free of all danger. The fixation of the isotope in the right sacroiliac (R.S.I.) and the "normal" limits of the fixation ratios R.S.I./L.R. and the lumbar rachis (L.R.), visible on the same film. A series of 28 controls having made it possible to calculate the "normal" limits of the fixation ratios R.S.I./L.R. and L.S.I./L.R., the isotopic fixation was measured in 25 patients with sacroiliac inflammation, 21 of whom were rheumatic, 3 infectious. It was shown that scintigraphy could yield useful information on the evolution of sacroiliac inflammation, making an early diagnosis possible, and also contributing to differentiation between rheumatic and infectious inflammation.

Topics: Adult; Aged; Arthritis, Reactive; Back Pain; Bacterial Infections; Bone and Bones; Diphosphates; Female; Humans; Ilium; Joint Diseases; Male; Middle Aged; Osteoarthritis; Psoriasis; Radionuclide Imaging; Rheumatic Diseases; Sacroiliac Joint; Sacrum; Spinal Diseases; Spondylitis, Ankylosing; Staphylococcal Infections; Technetium; Tuberculosis, Spinal

Twelve patients with severe hypothyroidism and rheumatic signs and symptoms were studied before or within four days of receiving thyroid replacement therapy. Eight patients had synovial effusions. Seven effusions were extremely viscous and six contained calcium pyrophosphate crystals. Leukocyte counts were less than 1,000/mm3, except in two patients during crystal-induced synovitis. "Bulge signs" were present but often sluggish, possibly because of the viscosity of the fluid. Flexor tendon sheath thickening, joint laxity and popliteal cysts were documented. All patients complained of generalized stiffness and two had proximal myopathy. Roentgenograms were obtained in 11 patients, and chondrocalcinosis was identified in seven. Needle synovial biopsy specimens in five patients showed only mild inflammation in the thick synovium. These findings can suggest hypothyroidism, a treatable disease, as the cause of musculoskeletal problems.

Topics: Aged; Calcium Phosphates; Chondrocalcinosis; Diphosphates; Female; Humans; Hyaluronic Acid; Hypothyroidism; Joint Diseases; Male; Middle Aged; Radiography; Rheumatic Diseases; Synovial Fluid; Synovial Membrane; Viscosity

Topics: Arthritis; Bone Diseases; Bone Neoplasms; Diagnosis, Differential; Diphosphates; Hodgkin Disease; Humans; Multiple Myeloma; Neoplasm Metastasis; Osteitis Deformans; Osteoarthritis; Osteolysis; Osteomalacia; Osteoporosis; Radionuclide Imaging; Reflex Sympathetic Dystrophy; Rheumatic Diseases; Technetium; Tin

Topics: Arthritis; Arthritis, Rheumatoid; Calcinosis; Calcium Phosphates; Cartilage; Cartilage, Articular; Chondrocalcinosis; Classification; Diagnosis, Differential; Diphosphates; Geriatrics; Gout; Humans; Joint Diseases; Knee; Lupus Erythematosus, Systemic; Pathology; Radiography; Rheumatic Diseases; Synovial Fluid

Topics: Arthritis; Calcinosis; Chondrocalcinosis; Diphosphates; Humans; Rheumatic Diseases; Synovitis