Document Detail

Intracellular and extracellular CPPD crystals are a regular feature in synovial fluid from uninflamed joints of patients with CPPD related arthropathy.
MedLine Citation:
PMID:  15941838     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine whether calcium pyrophosphate dihydrate (CPPD) crystals can be found in the synovial fluid of non-inflamed joints in patients with CPPD related arthropathy; if so, to determine whether they interact with cells and produce subclinical inflammation in this setting. METHODS: 74 synovial fluid samples were obtained from non-inflamed knees of 74 patients with CPPD related arthropathy. Identification of CPPD crystals and synovial fluid cell counts were done manually in undiluted samples using a haematocytometric chamber. A supravital stain (Testsimplets, Boehringer Mannheim) was used to carry out differential counts and to assess the presence of intracellular crystals. RESULTS: All 74 samples contained CPPD crystals. The mean cell count was 301.4 cells/microl (95% confidence interval (CI), 216.6 to 386.4; range 22 to 2302.5). Mononuclear cells accounted for 83.2% (95% CI, 80.4% to 86.1%; range 43% to 99%), the rest being polymorphonuclear (PMN) cells (16.8% (95% CI, 13.9% to 19.6%; range 1% to 57%)). All the samples contained intracellular CPPD crystals, which were found in 24.0% of all the cells (95% CI, 20.1% to 27.9%; range 1% to 78%). Most of the intracellular crystals were inside mononuclear cells (22.2% of all the cells (95% CI, CI 18.5% to 25.9%)), although some PMN also contained them (1.8% of all the cells (95% CI, 1.1% to 2.4%)). CONCLUSIONS: CPPD crystals are normally found in synovial fluid of non-inflamed joints of patients with CPPD related arthropathy, and they interact with cells. The raised cell counts and percentage of PMN suggest mild subclinical inflammation in these joints.
A Martínez Sanchis; E Pascual
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Publication Detail:
Type:  Journal Article     Date:  2005-06-07
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  64     ISSN:  0003-4967     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2005-11-14     Completed Date:  2006-01-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  1769-72     Citation Subset:  IM    
Calle Pintor Baeza, s/n Alicante 03010, Spain.
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MeSH Terms
Aged, 80 and over
Calcium Pyrophosphate / analysis*
Cell Count
Chondrocalcinosis / metabolism*,  pathology
Knee Joint / chemistry*,  pathology
Leukocyte Count
Middle Aged
Neutrophils / pathology
Synovial Fluid / chemistry*,  cytology
Reg. No./Substance:
10086-45-0/Calcium Pyrophosphate

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