ISSN: 2577-297X
Authors: Miklós Bély* and Apáthy A
Gout (G), apatite rheumatism (AR), chondrocalcinosis (Ch-C), and primary synovial chondromatosis (prSynCh) are regarded as distinct clinical entities. The introduction of the non-staining technique by Bély and Apáthy (2013) opened a new era in the microscopic diagnosis of crystal induced diseases, allowing demonstration of MSU, HA, CPPD, cholesterol, crystalline liquid lipid droplets, and several other non-identified crystals in unstained sections of conventionally processed (aqueous formaldehyde fixed, paraffinembedded) tissue samples. Aim of this study was to describe the characteristic histology of crystal deposits in G, AR, Ch-C, and prSynCh with traditional stains and histochemical reactions comparing with unstained tissue sections of Bély and Apáthy (2013). Patients and Methods: Tissue samples of 146 patients with clinically diagnosed gout, 4 with apatite rheumatism (Milwaukee syndrome), 16 with chondrocalcinosis, and 20 with clinically diagnosed primary synovial chondromatosis were analyzed. Results and Conclusions: Gout is a distinct metabolic disease with monomorphic MSU crystal deposits, while apatite rheumatism, chondrocalcinosis, and primary synovial chondromatosis are related metabolic disorders with HA and CPPD depositions. The authors assume that AR and Ch-C are different stages of the same metabolic disorder, which differ from prSynCh in amorphous mineral production, furthermore in the production of chondroid, osteoid and/or bone. prSynCh is a defective variant of HA and CPPD induced metabolic arthropathy with reduced mineralization which is replaced with chondroid and/or bone formation. The non-staining technique of Bély and Apáthy proved to be a much more effective method for the demonstration of crystals in metabolic diseases than conventional stains and histochemical reactions.
Keywords: Gout; Apatite Rheumatism; Chondrocalcinosis; Primary Synovial Chondromatosis; Conventional Stains; Non-Staining Technique
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