musculoskeletal and connective tissue disorders
Basic Calcium Phosphate Crystal Deposition Disease and Calcium Oxalate Crystal Deposition Disease
Basic calcium phosphate crystal deposition disease
. These ultramicroscopic crystals occur in snowball-like clumps in rheumatic conditions (eg, calcific tendinitis, calcific periarthritis, some cases of progressive Systemic Sclerosis and BCP crystals can destroy joints and can cause severe intra-articular or periarticular inflammation. Milwaukee shoulder/knee syndrome,a chronic destructive arthropathy affecting predominantly older women that usually develops in the shoulders and often knees, is one example. The syndrome is characterized by chronic large but minimally inflammatory synovial effusions. due to periarticular BCP deposition can mimic Gout ; it occurs as a discrete syndrome in young women (less often in young men) and is Besides synovial fluid analysis, x-rays should be taken of symptomatic joints. On x-ray, BCP crystals may be visible as periarticular cloudlike opacities; the crystals often spontaneously resolve over months or occasionally within days. Definitive assay for BCP crystals in synovial fluid is not readily available. Clumped crystals can usually be identified only with special calcium stains or transmission electron microscopy. The clumps are not birefringent under polarized light. , an NSAID, or, if a large joint is involved, intra-articular corticosteroid ester crystal suspension is helpful. Treatment is the same as that for Treatment of acute flares . 