Diagnosis and therapy of crystal-induced diseases

Clinical symptoms as well as the classification criteria of gout are presented. Identification of monosodium urate monohydrate crystals in synovial fluid or tophus aspirates permits a definite diagnosis of gout. Oral colchicine and/or non‑steroidal anti-inflammatory drugs (NSAIDs) are first line agents for treatment of acute attacks. The therapeutic goal of urate lowering therapy is maintaining the serum uric acid ≤ 6 mg/dl (375 μmol/l).
Definite diagnosis of calcium pyrophosphate deposition (CPPD) is by identification of calcium pyrophosphate crystals in synovial fluid or biopsied tissue. Radiographic chondrocalcinosis supports the diagnosis. For acute calcium pyrophosphate crystal arthritis, joint aspiration combined with steroid injection is often sufficient. Oral colchicine and/or (NSAIDs) are an effective alternative.

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