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The added value of synovial fluid centrifugation for monosodium urate and calcium pyrophosphate crystal detection.
Clin Rheumatol. 2017 Jul; 36(7):1599-1605.CR

Abstract

The aim of the study was to assess the added value of synovial fluid (SF) centrifugation for microscopic monosodium urate (MSU) and calcium pyrophosphate (CPP) crystal detection in patients with arthritis. This is a prospective observational study using SF samples from joints of patients undergoing joint arthrocentesis. Two blinded observers assessed the SF smears by polarized light microscopy for the presence of crystals before as well as after centrifugation. SF samples were collected from 98 patients with arthritis. After exclusion, 87 samples were eligible for inclusion. Of each sample, 2 smears before and after centrifugation were prepared and microscopically examined, resulting in 348 smears per observer. Observer 1 identified MSU crystals in 18.4% and CPP in 9.2% of the smears before as well as after centrifugation. No extra MSU crystal-positive smears were identified after centrifugation. However, centrifugation yielded 4 additional CPP crystal-positive smears. Observer 2 identified MSU crystals in 15.5% and CPP crystals in 6.3% of the smears before as well as after centrifugation. Centrifugation yielded 2 additional MSU crystal-positive smears and 4 CPP crystal-positive smears. Monosodium urate crystals were well recognized without centrifugation. Centrifugation of SF had limited additional value for increasing the amount of MSU-positive smears. However, CPP crystals were identified in a higher number of smears after centrifugation than before. Therefore, centrifugation may be of additional value in selected patients with suspected calcium pyrophosphate deposition disease and to a lesser extent for gout.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Boumans D
Arthritis Centre Twente at Medisch Spectrum Twente, Enschede, The Netherlands. d.boumans@zgt.nl. Department of Rheumatology, Ziekenhuisgroep Twente (ZGT), PO Box 7600, 7600 SZ, Almelo, The Netherlands. d.boumans@zgt.nl.
Hettema ME
Arthritis Centre Twente at Medisch Spectrum Twente, Enschede, The Netherlands.
Vonkeman HE
Arthritis Centre Twente at Medisch Spectrum Twente, Enschede, The Netherlands.
Maatman RG
Medlon Laboratory, Medisch Spectrum Twente, Enschede, The Netherlands.
van de Laar MA
Arthritis Centre Twente at Medisch Spectrum Twente, Enschede, The Netherlands.

MeSH

AdultAgedAged, 80 and overCalcium PyrophosphateCentrifugationChondrocalcinosisFemaleGoutHumansMaleMicroscopy, PolarizationMiddle AgedProspective StudiesSynovial FluidUric AcidYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28424907

Citation

Boumans, D, et al. "The Added Value of Synovial Fluid Centrifugation for Monosodium Urate and Calcium Pyrophosphate Crystal Detection." Clinical Rheumatology, vol. 36, no. 7, 2017, pp. 1599-1605.
Boumans D, Hettema ME, Vonkeman HE, et al. The added value of synovial fluid centrifugation for monosodium urate and calcium pyrophosphate crystal detection. Clin Rheumatol. 2017;36(7):1599-1605.
Boumans, D., Hettema, M. E., Vonkeman, H. E., Maatman, R. G., & van de Laar, M. A. (2017). The added value of synovial fluid centrifugation for monosodium urate and calcium pyrophosphate crystal detection. Clinical Rheumatology, 36(7), 1599-1605. https://doi.org/10.1007/s10067-017-3633-6
Boumans D, et al. The Added Value of Synovial Fluid Centrifugation for Monosodium Urate and Calcium Pyrophosphate Crystal Detection. Clin Rheumatol. 2017;36(7):1599-1605. PubMed PMID: 28424907.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The added value of synovial fluid centrifugation for monosodium urate and calcium pyrophosphate crystal detection. AU - Boumans,D, AU - Hettema,M E, AU - Vonkeman,H E, AU - Maatman,R G, AU - van de Laar,M A, Y1 - 2017/04/19/ PY - 2016/12/20/received PY - 2017/04/11/accepted PY - 2017/04/05/revised PY - 2017/4/21/pubmed PY - 2018/3/30/medline PY - 2017/4/21/entrez KW - Calcium pyrophosphate deposition disease KW - Crystal arthropathies KW - Diagnostic tests KW - EDTA and polarized microscopy KW - Gout KW - Synovial fluid centrifugation SP - 1599 EP - 1605 JF - Clinical rheumatology JO - Clin Rheumatol VL - 36 IS - 7 N2 - The aim of the study was to assess the added value of synovial fluid (SF) centrifugation for microscopic monosodium urate (MSU) and calcium pyrophosphate (CPP) crystal detection in patients with arthritis. This is a prospective observational study using SF samples from joints of patients undergoing joint arthrocentesis. Two blinded observers assessed the SF smears by polarized light microscopy for the presence of crystals before as well as after centrifugation. SF samples were collected from 98 patients with arthritis. After exclusion, 87 samples were eligible for inclusion. Of each sample, 2 smears before and after centrifugation were prepared and microscopically examined, resulting in 348 smears per observer. Observer 1 identified MSU crystals in 18.4% and CPP in 9.2% of the smears before as well as after centrifugation. No extra MSU crystal-positive smears were identified after centrifugation. However, centrifugation yielded 4 additional CPP crystal-positive smears. Observer 2 identified MSU crystals in 15.5% and CPP crystals in 6.3% of the smears before as well as after centrifugation. Centrifugation yielded 2 additional MSU crystal-positive smears and 4 CPP crystal-positive smears. Monosodium urate crystals were well recognized without centrifugation. Centrifugation of SF had limited additional value for increasing the amount of MSU-positive smears. However, CPP crystals were identified in a higher number of smears after centrifugation than before. Therefore, centrifugation may be of additional value in selected patients with suspected calcium pyrophosphate deposition disease and to a lesser extent for gout. SN - 1434-9949 UR - https://www.unboundmedicine.com/medline/citation/28424907/The_added_value_of_synovial_fluid_centrifugation_for_monosodium_urate_and_calcium_pyrophosphate_crystal_detection_ L2 - https://dx.doi.org/10.1007/s10067-017-3633-6 DB - PRIME DP - Unbound Medicine ER -