Crystalline Arthropathies

The Rheumatology Program at UT Southwestern Medical Center is recognized as among the best in the country for rheumatic diseases including crystalline arthropathies. Our specialists provide expert, compassionate care with accurate diagnostic services and effective treatments that make a difference in patients’ lives.

Experienced Treatment for Crystalline Arthropathies

Crystalline arthropathies are a group of joint disorders caused by deposits of crystals in joints and the soft tissues around them. The most common types are gout and calcium pyrophosphate deposition (CPPD). Over time, crystalline arthropathies can lead to joint damage and occasionally kidney disease. 

Our doctors bring the most advanced therapies and diagnostic methods to the bedside for people with rheumatic diseases. Combining expertise with the newest medical resources, we help our patients return to their full and active lives.

Causes and Risk Factors of Crystalline Arthropathies

Gout, a common type of crystalline arthropathy, results from a buildup of urate crystals in a joint, causing pain and inflammation. Urate crystals can form in people who have high levels of uric acid in the blood. This can happen when the body produces too much uric acid or the kidneys cannot remove enough.

CPPD, also known as pseudogout, occurs when calcium pyrophosphate dihydrate crystals build up in a joint. However, most people who have such deposits never develop CPPD, so its exact causes are not yet fully understood.

Certain factors can increase the risk of developing gout, such as:

• Diet rich in meat, seafood, alcohol, and beverages containing fruit sugar (fructose)
  
• Obesity
  
• Health conditions such as high blood pressure, diabetes, and heart and kidney diseases
  
• Medications such as diuretics to treat high blood pressure and immunosuppressants to prevent organ rejection in transplant recipients
  
• Family history of gout
  
• Recent surgery or injury

Risk factors for CPPD include:

• Older age
  
• Previous joint surgery or trauma
  
• Inherited genetic disorder
  
• High levels of calcium or iron in the blood
  
• Low level of magnesium in the blood
  
• Overactive or underactive thyroid
  

Symptoms of Crystalline Arthropathies

Symptoms of gout typically occur at night and include:

• Severe pain in joints of the big toe, ankles, knees, elbows, wrists, and fingers
  
• Milder, lingering joint pain
  
• Redness and inflammation
  
• Reduced range of motion

Some people with CPPD experience no symptoms. If symptoms appear, they include extreme joint pain, swelling, and warmth.

Diagnosing Crystalline Arthropathies

Our rheumatologists (doctors who specialize in diseases that affect joints, bones, muscles, and the immune system) conduct a thorough evaluation, which includes a:

• Physical exam
  
• Discussion of personal and family medical history
  
• Discussion of symptoms and risk factors

To confirm a diagnosis of a crystalline arthropathy, our doctors might recommend one or more tests, such as:

• Blood tests to check blood levels of iron, calcium, magnesium, and uric acid and to look for thyroid hormone imbalances
  
• Tests of fluid taken from an affected joint to check for crystals
  
• Imaging, such as X-rays, to check for joint damage and the presence of crystals
  

Treatment for Crystalline Arthropathies

Medications can treat gout attacks, prevent future attacks, and prevent complications such as kidney stones. For gout, our rheumatologists typically recommend:

• Pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) or colchicine
  
• Corticosteroid pills or injections into the affected joint to reduce pain and inflammation
  
• Medications that block uric acid production, known as xanthine oxidase inhibitors (XOIs)
  
• Medications that promote uric acid removal, known as uricosurics
  
• Biological medications that can convert uric acid into more soluble compounds that are less likely to cause acute gout

Our treatment options for CPPD include:

• Pain relievers such as NSAIDs or colchicine
  
• Corticosteroid pills or injections into the affected joint to reduce pain and inflammation
  
• Joint drainage using a needle to remove some fluid along with crystals from the joint