Triple crystal disease: monosodium urate monohydrate, calcium pyrophosphate dihydrate, and basic calcium phosphate in a single joint.
A 49 year old man is described with a polyarticular arthritis. Synovial fluid aspirated from the knee joint showed monosodium urate monohydrate and calcium pyrophosphate dihydrate by polarised light microscopy. Additionally, diphosphonate binding and scanning electron microscopy with energy dispersive analysis showed that basic calcium phosphate crystals were also present. This appears to be the first report of three crystals occurring simultaneously in a single joint.
Halverson
P B
PB
Division of Rheumatology, Medical College of Wisconsin, Milwaukee 53226.
Ryan
L M
LM
D001168:Arthritis / Q000378:metabolism*; D002130:Calcium Phosphates / Q000032:analysis*; D002131:Calcium Pyrophosphate / Q000032:analysis*; D003460:Crystallization; D011756:Diphosphates / Q000032:analysis*; D006801:Humans; D007719:Knee Joint / Q000032:analysis; D008297:Male; D008875:Middle Aged; D014527:Uric Acid / Q000032:analysis*
D002130:Calcium Phosphates; D011756:Diphosphates; C485828:alpha-tricalcium phosphate; C485830:tetracalcium phosphate; D014527:Uric Acid; C485838:calcium phosphate, monobasic, anhydrous; C020243:calcium phosphate; C485829:calcium phosphate, dibasic, anhydrous; D002131:Calcium Pyrophosphate