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Hydroxyapatite Crystal Disease

Medical Author: William C. Shiel Jr., MD, FACP, FACR

What is hydroxyapatite?

Hydroxyapatite is the major component, and an essential ingredient, of normal bone and teeth. It is hydroxyapatite that makes up bone mineral and the matrix of teeth.

What are hydroxyapatite crystals?

Hydroxyapatite molecules can group together (crystallize) to form microscopic clumps, called hydroxyapatite crystals.

Tiny crystals of hydroxyapatite sometimes form in or around joints and can cause inflammation of joints and tissues around the joints, such as tendons and ligaments. They have been described particularly as a cause of rotator cuff inflammation of the shoulder.

The inflammation caused by hydroxyapatite crystals has been referred to as hydroxyapatite crystal disease.

Is hydroxyapatite crystal disease the same as gout or pseudogout?

No. These conditions are similar in that they are all caused by the inflammation that results from the body's reaction to crystals. However, hydroxyapatite crystals are distinctly different from the crystals of pseudogout or gout. While hydroxyapatite crystals can sometimes also be found in the company of the calcium pyrophosphate crystals characteristic of pseudogout, these are quite different types of crystals.

How are hydroxyapatite crystals identified?

Sometimes, hydroxyapatite crystals can be seen clumped in the fluid of a joint that has developed arthritis. The crystals are usually so small as to be invisible under a regular microscope and thus require a special (electron) microscope for identification.

How is hydroxyapatite crystal disease treated?

The treatment of the inflammation caused by hydroxyapatite crystals includes rest, cold application, and medications to reduce inflammation. Cortisone-related medications injected into inflamed tissues can also sometimes help decrease inflammation and thereby relieve pain.

Hydroxyapatite Crystal Disease At A Glance
  • Hydroxyapatite is an essential mineral of normal bone.
  • Crystals of hydroxyapatite deposited in and about the joints cause inflammation.
  • Inflammation and pain are part of hydroxyapatite crystal disease.
  • This disease is distinct and different from gout and pseudogout.
  • Treatment includes measures to reduce inflammation and pain.

Last Editorial Review: 2/27/2008




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Hydroxyapatite Crystal Disease

What is pseudogout?

Pseudogout is a type of inflammation of joints (arthritis) that is caused by deposits of crystals, called calcium pyrophosphate, in and around the joints. Pseudogout literally means "false gout."

Pseudogout has many similarities to true gout, which also can cause arthritis. However, the crystal that incites the inflammation of gout is monosodium urate. The crystals that cause pseudogout and gout each have distinct appearances when joint fluid containing them is viewed under a microscope. This makes it possible to precisely identify the cause of the joint inflammation when joint fluid is available.

Pseudogout has been reported to occasionally coexist with gout. This means that the two types crystals can sometimes be found in the same joint fluid. Researchers have also noted that the cartilage of patients who had both forms of crystals in their joint fluid was often visibly calcified, as seen on x-ray images.

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Read the Pseudogout article »










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