Latest revision as of 04:58, 24 April 2016

Crystals (gout) and blood cells in polarized light. (WC/Gabriel Caponetti)

Crystals in urine. (WC)

This article deals with crystals in body fluids.

Crystals

Joint crystals

Types:^[1]

Gout = needle-shaped, negatively birefringent, yellow when aligned.
Pseudogout = rhomboid-shaped, positively birefringent, blue when aligned.

Notes:

Pseudogout also known as CPPD = calcium pyrophosphate dehydrogenase.
Memory device: ABC+ = aligned blue is calcium & cuboid - positively birefringent.

Urine crystals

Types - morphology:

Envelope shape (calcium oxalate).
Diamond shape (uric acid).
Coffin-lid shape (struvite).
Hexagonal shape (cysteine).

Notes:

Memory devices:
- Diamonds are see-through; ergo, uric acid stones not seen on KUB.
- Calcium oxalate = envelope, uric acid = diamond.
Uric acid crystals: usually dissolve in formalin... but do not dissolve in alcohol.^[2]^[3]
Calcium oxalate crystals are seen in the context of ethylene glycol poisoning.^[4]

Images

Struvite crystals. (WC)
Uric acid crystals. (WC)
Calcium oxalate crystal - envelope-shaped. (WC)
Uric acid crystals. (WC)

Case

Crystals - high mag.
Crystals - high mag.
Crystals - very high mag.
Crystals - very high mag.
Crystals - very high mag.

www

Uric acid crystals - schematic from 1844. (wikipedia.org)

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Urine cytology

Negative for malignant cells.
Mainly squamous cells present. Cuboidal/rhomboidal crystals present.

Diseases

Gout

Main article: Gout

Pseudogout

AKA Calcium pyrophosphate dihydrate deposition disease,^[5] abbreviated CPPD.

Main article: Chondrocalcinosis

References

↑ Yeung, J.C.; Leonard, Blair J. N. (2005). The Toronto Notes 2005 - Review for the MCCQE and Comprehensive Medical Reference (2005 ed.). The Toronto Notes Inc. for Medical Students Inc.. pp. RH6. ISBN 978-0968592854.
↑ Geddie, W. 8 January 2010.
↑ Shidham, V.; Chivukula, M.; Basir, Z.; Shidham, G. (Aug 2001). "Evaluation of crystals in formalin-fixed, paraffin-embedded tissue sections for the differential diagnosis of pseudogout, gout, and tumoral calcinosis.". Mod Pathol 14 (8): 806-10. doi:10.1038/modpathol.3880394. PMID 11504841.
↑ Saukko, Pekka; Knight, Bernard (2004). Knight's Forensic Pathology (3rd ed.). A Hodder Arnold Publication. pp. 589. ISBN 978-0340760444.
↑ URL: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001458/. Accessed on: 28 October 2011.

External links

[1] Yeung, J.C.; Leonard, Blair J. N. (2005). The Toronto Notes 2005 - Review for the MCCQE and Comprehensive Medical Reference (2005 ed.). The Toronto Notes Inc. for Medical Students Inc.. pp. RH6. ISBN 978-0968592854.

[2] Geddie, W. 8 January 2010.

[3] Shidham, V.; Chivukula, M.; Basir, Z.; Shidham, G. (Aug 2001). "Evaluation of crystals in formalin-fixed, paraffin-embedded tissue sections for the differential diagnosis of pseudogout, gout, and tumoral calcinosis.". Mod Pathol 14 (8): 806-10. doi:10.1038/modpathol.3880394. PMID 11504841.

[Ref_KFP589-4] Saukko, Pekka; Knight, Bernard (2004). Knight's Forensic Pathology (3rd ed.). A Hodder Arnold Publication. pp. 589. ISBN 978-0340760444.

[5] URL: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001458/. Accessed on: 28 October 2011.

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@@ Line 32: / Line 32: @@
 Image: Uric acid crystals (urine) - Ürik asit kristalleri (idrar) - 03.png | Uric acid crystals. (WC)
 Image: Calcium oxalate crystals in urine.jpg | Calcium oxalate crystal - envelope-shaped. (WC)
+Image: Fluorescent uric acid.JPG | Uric acid crystals. (WC)
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Difference between revisions of "Crystals in body fluids"