Gout and crystal deposition arthritis

Abstract

Certain types of joint pain, effusions and arthritis are now recognized to be a result of crystal deposition in the synovial membrane. Apparently the crystals attract immunoglobulins to their negatively charged surfaces and thereby initiate an inflammatory reaction in the joint. While most cases of chondrocalcinosis are idiopathic, we are beginning to discover a metabolic or endocrine basis for the deposition of these crystals. Of course, it has been known for some time that urate crystals, formed as a result of hyperuricaemia — either as a primary metabolic error in which excessive uric acid is formed or secondary to excessive production or insufficient excretion of urate — are responsible for gouty attacks. More recently, various types of arthritis due to deposition of calcium salts have been recognized; the acute varieties which very much resemble classical gout are called pseudogout.