Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
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.
Gout is a condition that results from crystals of uric acid depositing in tissues of the body. Gout is a condition that can lead to abnormally elevated levels of uric acid in the
blood, recurring attacks of joint inflammation (arthritis), deposits of
hard lumps of uric acid in and around the joints, and decreased kidney
function and kidney stones.
Pseudogout, a form of arthritis, results when deposits of crystals collect in and around the joints. Symptoms of pseudogout include pain, stiffness, warmth, and joint swelling of the knees, ankles, hips, shoulders, and/or wrists. Treatment for pseudogout aims to decrease inflammation through the use of nonsteroidal antiinflammatory drugs, ice, and rest.
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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