The ordinary light microscope: an appropriate tool for provisional detection and identification of crystals in synovial fluid

Article Abstract:

The effectiveness of the ordinary light microscope in detecting and identifying crystals in the synovial, or joint, fluid was evaluated. Among the samples of synovial fluid examined, 13 samples were known to contain monosodium urate (MSU) crystals, 35 samples consisted of calcium pyrophosphate dihydrate (CPPD) crystals, one sample contained both crystal types, and 35 samples had no crystals. The samples were examined separately by two observers using an ordinary light microscope, and then using a polarizing light microscope. The crystals were identified by shape. The sensitivity of the ordinary light microscope for detecting the crystals was 96.2 percent and 100 percent (relative to the polarizing microscope) for two different observers. The ability of the light microscope to identify MSU and CPPD crystals by shape was 92.3 percent and 85.6 percent for the first and second observer, respectively. The results show that an ordinary light microscope may provide preliminary diagnosis of crystals in the synovial fluid, but definitive identification of the crystal type requires polarizing light microscopy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Medical examination, Microscopy, Medical, Medical microscopy

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Identification of crystals in synovial fluid

Article Abstract:

The presence of certain crystals in synovial fluid, specifically the pathogenic monosodium urate monohydrate (MSUM) or calcium pyrophosphate dihydrate (CPPD), should change the method of treatment being use, and because of that, identification of them is crucial. The use of polarized light microscopy seems to be the only relatively practical test which will identify them. There are major problems encountered in using this test in cases of low concentration of crystals or unusually small crystals, possibly giving a false negative. These problems must be met with good equipment, good laboratory practice, good training and quality control systems.

Identification and classification, Pathogenic microorganisms

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Urinary albumin excretion in patients with systemic lupus erythematosus without renal disease

Article Abstract:

The presence of urinary albumin in patients with systemic lupus erythematosus (SLE) does not seem to be an indicator of developing kidney disease. In an 18-month follow-up of 22 women with SLE who had variable amounts of urinary albumin, no ensuing kidney disease was detected. Although urinary albumin excretion is considered a sensitive indicator of possible kidney problems in connection with diabetes mellitus and hypertension, it does not seem to be problematic when present in patients with SLE.

Diagnosis, Measurement, Risk factors, Systemic lupus erythematosus, Kidney diseases, Albumin, Proteinuria

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