Galozzi Paola, Oliviero Francesca, Frallonardo Paola, Favero Marta, Hoxha Ariela, Scanu Anna, Lorenzin Mariagrazia, Ortolan Augusta, Punzi Leonardo, Ramonda Roberta
Rheumatology Unit, Department of Medicine - DIMED, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.
Rheumatol Int. 2016 Mar;36(3):443-6. doi: 10.1007/s00296-015-3376-0. Epub 2015 Oct 6.
The aim of this study was to assess the frequency of monosodium urate (MSU) and calcium pyrophosphate (CPP) crystals in synovial fluids (SFs) aspirated from wrist and finger joints of patients with previously diagnosed joint diseases. We reviewed the results of SF analysis of 1593 samples and identified 126 patients with effusions in the small joints of the hands and wrists. We reported from patients' medical files data about sex, age, diagnosis, disease duration and the microscopic SF results. The prevalence of CPP crystals in SF was 85.71% in CPP-crystals arthritis (CPP-CA), 19.35% in rheumatoid arthritis (RA), 13.89% in osteoarthritis (OA) and 0% in psoriatic arthritis (PsA), spondyloarthritis (SpA), gout and miscellanea. The prevalence of MSU crystals in SF was 83.3% in gout, 10% in PsA, 2.8% in OA and 0% in RA, SpA, miscellanea and CPP-CA. Consistent with previously reported data concerning the big joints, microcrystals can be frequently found also in the small joints of patients with previous diagnosis. The finding underlines the importance of analyzing SF from the hand and wrist joints in the attempt to identify comorbidities associated with the presence of crystals and to develop targeted treatment strategies.
本研究的目的是评估从先前诊断为关节疾病的患者手腕和手指关节抽取的滑液（SF）中尿酸钠（MSU）和焦磷酸钙（CPP）晶体的出现频率。我们回顾了1593份样本的SF分析结果，确定了126例手部和手腕小关节积液的患者。我们从患者的病历中报告了有关性别、年龄、诊断、病程以及SF显微镜检查结果的数据。在焦磷酸钙晶体关节炎（CPP-CA）中，SF中CPP晶体的患病率为85.71%，类风湿性关节炎（RA）中为19.35%，骨关节炎（OA）中为13.89%，银屑病关节炎（PsA）、脊柱关节炎（SpA）、痛风和其他疾病中为0%。SF中MSU晶体的患病率在痛风中为83.3%，PsA中为10%，OA中为2.8%，RA、SpA、其他疾病和CPP-CA中为0%。与先前关于大关节的报道数据一致，在先前已确诊的患者的小关节中也经常能发现微晶。这一发现强调了分析手部和手腕关节SF对于识别与晶体存在相关的合并症以及制定针对性治疗策略的重要性。
