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词条 Crystal arthropathy
释义

  1. Risk factors

  2. Causes

  3. Differential diagnosis

  4. References

  5. External links

{{Infobox medical condition (new)
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| field = Rheumatology
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}}Crystal arthropathy is a class of joint disorder (called arthropathy) that is characterized by accumulation of tiny crystals in one or more joints. Polarizing microscopy and application of other crystallographic techniques have improved identification of different microcrystals including monosodium urate, calcium pyrophosphate dihydrate, calcium hydroxyapatite, and calcium oxalate.[1]

Types include:

Name Substance Birefringence
Gout[2] accumulation of uric acid negative
Chondrocalcinosis[3] aka Pseudogout accumulation of calcium pyrophosphate positive

Risk factors

  • Obesity
  • Kidney failure
  • Hyperphosphatemia
  • Hyperparathyroidism
  • Hypercalcemia
  • Tissue damage (dystrophic calcification)

Causes

  • Deposition of crystals in joints
  • Calcium pyrophosphate dihydrate crystal formation:
    • Increased production of inorganic pyrophosphate
    • Decreased levels of pyrophosphatase in cartilage
    • Decreased levels of cartilage glycosaminoglycans
    • Hyperparathyroidism
    • Hemochromatosis[4]
    • Hypophosphatasia[5]
    • Hypomagnesemia
  • Hydroxyapatite deposition:
    • Tissue damage
    • Hyperparathyroidism[6]
    • Hypercalcemia
    • Hyperphosphatemia
  • Calcium oxalate deposition:
    • Enhanced production of oxalic acid due to enzyme defect
    • Poor excretion of oxalic acid in kidney failure
    • Excessive ascorbic acid intake in kidney failure

Differential diagnosis

  • Septic arthritis
  • Type IIa hyperlipoproteinemia
  • Amyloidosis
  • Multicentric reticulohistiocytosis
  • Hyperparathyroidism
  • Spondyloarthropathy
  • Rheumatoid arthritis
  • Fibromyalgia

References

1. ^{{cite journal |author=Mcgill NW |title=Gout and other crystal-associated arthropathies|journal=Baillière's Clinical Rheumatology |volume=14 |issue=3 |pages=445–460 |year=2000 |pmid=10985980 |doi=10.1053/berh.2000.0087}}
2. ^{{cite journal |author=Choi H |title=Epidemiology of crystal arthropathy |journal=Rheum. Dis. Clin. North Am. |volume=32 |issue=2 |pages=255–73, v |date=May 2006 |pmid=16716879 |doi=10.1016/j.rdc.2006.03.002 |url=http://linkinghub.elsevier.com/retrieve/pii/S0889-857X(06)00025-1}}
3. ^{{cite journal |vauthors=Canhão H, Fonseca JE, Leandro MJ |title=Cross-sectional study of 50 patients with calcium pyrophosphate dihydrate crystal arthropathy |journal=Clin. Rheumatol. |volume=20 |issue=2 |pages=119–22 |year=2001 |pmid=11346223 |doi= 10.1007/s100670170081|url=http://link.springer.de/link/service/journals/10067/bibs/1020002/10200119.htm|display-authors=etal}}
4. ^{{cite web|last1=Axford, DSc, MD|first1=John S.|title=Rheumatic manifestations of hereditary hemochromatosis|url=http://www.uptodate.com/contents/rheumatic-manifestations-of-hereditary-hemochromatosis|website=UpToDate.com|accessdate=10 September 2014}}
5. ^{{cite web|title=Hypophosphatasia Pathology|url=http://www.hypophosphatasia.com/hcp/pathology|website=Hypophosphatasia.com|accessdate=10 September 2014}}
6. ^{{cite journal|last1=Geelhoed|first1=GW|last2=Kelly|first2=TR|title=Pseudogout as a clue and complication in primary hyperparathyroidism|journal=Surgery|date=December 1989|volume=106|issue=6|pages=1036–42|pmid=2588110}}

External links

{{Medical resources
| DiseasesDB =
| ICD10 = {{ICD10|M|10||m|05}}-{{ICD10|M|11||m|05}}
| ICD9 = {{ICD9|712}}
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}}{{Diseases of the musculoskeletal system and connective tissue}}

1 : Inflammatory polyarthropathies

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