Synovial fluid pyrophosphate and nucleoside triphosphate pyrophosphatase: comparison between normal and diseased and between inflamed and non-inflamed joints

Article Abstract:

Joints are affected by the normal aging process and certain physiological changes occurring in the joints have been associated with age. For example, the development and accumulation of calcium crystals within joints increases with time and is associated with the development of a particular type of joint disease called pyrophosphate arthropathy. The exact relationship between the formation of calcium crystals within in the joint and the development of inflammation and joint disease is not known. It has been suggested that the crystals either cause joint disease or are formed as a result of injury to the joint. Inorganic pyrophosphate (PPi) may play some role in the formation of crystal deposits within the joint, and the amount of PPi present in the joint may be important. A study was performed to determine if patients with joint disease have greater amounts of PPi in their joints (as well as an enzyme called NTPase, which makes PPi), than patients without joint disease. Samples of joint fluid (synovial fluid) were taken from the knees of 44 patients with rheumatoid arthritis, 61 with pyrophosphate arthropathy, 59 with osteoarthritis (degradation or loss of joint cartilage) and 50 without joint disease. The samples were tested for the presence of PPi and NTPase. The greatest amounts of PPi and NTPase were found in patients with pyrophosphate arthropathy, osteoarthritis or rheumatoid arthritis. The amounts of PPi and NTPase were greater in the joints of patients with pyrophosphate arthropathy than in those of patients without joint disease. There was no relationship between age and levels of PPi or NTPase. It is concluded that factors other than PPi, such as inflammation and diagnosis, should be considered in joint diseases associated with the formation of calcium crystals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Abnormalities, Knee, Synovial fluid, Body fluids

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Crystal deposition in hypophosphatasia: a reappraisal

Article Abstract:

Hypophosphatasia is a rare hereditary disease characterized by abnormalities of phosphate metabolism, including low blood levels of the alkaline phosphatase enzyme, increased excretion of phosphoethanolamine in the urine, and increased levels of inorganic pyrophosphate (PPi) in the blood and urine. Symptoms of hypophosphatasia include inability to thrive in infants (which is associated with a high death rate); a condition resembling rickets (bone malformation) in childhood; and multiple fractures due to osteopenia (decreased bone tissue) in adults. The severity of the disease varies, especially in adults. Hypophosphatasia is also associated with polyarticular chondrocalcinosis, a gout-like disorder resulting from the deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the joints. In hypophosphatasia, the deficiency in alkaline phosphatase results in increased PPi levels, which cause deposition of CPPD crystals in the joints and prevents the formation and growth of apatite, a bone mineral containing phosphate and calcium. Among six patients with adult onset hypophosphatasia, three had calcific periarthritis (calcium-related inflammation of area around the joint) and two had osteopenic fracture. The remaining patient, the father of a patient with calcific periarthritis, had no symptoms. All patients were over 70 years of age and had a gout-like disorder due to deposition of CPPD crystals in the joints. Spinal hyperostosis, the abnormal growth of the spine, was also detected in four patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Evaluation, Bone diseases, Metabolism, Familial diseases, Phosphorus (Chemical element), Phosphorus metabolism

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Association of radiographic changes of osteoarthritis, symptoms, and synovial fluid particles in 300 knees

Article Abstract:

The presence of calcium crystals in the synovial fluid of the knees appears to be associated with the development of osteoarthritis. Three hundred osteoarthritic knees from 178 patients between the ages of 33 and 96 were examined. All patients had joint space loss in at least one compartment of the knee, but because many patients with osteoarthritis have symptoms only periodically or not at all, patients with and without knee symptoms were included. Calcium crystals were detected in 64% of the knees. The presence of calcium crystals was associated with a higher degree of joint space loss, hardening and bony growths. Calcium crystals were more likely to be detected in knees in which two or three compartments were osteoarthritic than in knees in which only one compartment was osteoarthritic. Patients with knees with two types of calcium crystals were more likely to have symptoms than than those with no crystals in their knees.

Osteoarthritis, Calcium in the body, Calcium (Nutrient)

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