Crystal-induced arthritis and osteoarthritis：晶体性关节炎和骨关节炎.pptVIP

* * * * * * * * Other kidney diseases Uric acid nephropathy- precippitation of uric acid crystals in collecting ducts resulting in acute renal failure, as in tumor lysis syndrome Urate nephropathy- deposition of monosodium urate crystals in the renal interstitial tissue causing mild and intermittent proteinuria and rarely renal dysfunction Polycystic kidney disease- one third of patients have gout * URAT-1 is an organic anion transporter and is the major mechanism of reabsorbtion of urate in the proximal tubule in the human kidney. * * Pseudo RA is seen in ~5% of patients. No erosions. Pseudo-OA is seen in 50% of patients. The association between CPPD and the acceleration of the garden-variety OA is questionable (some studies support, but more recent studies don’t). * * * * * * * * * * * * * * * * 4-P-2 Degenerative joint disease: toe (photomicrograph) This section of the first metatarsophalangeal joint shows partial erosion on both surfaces of the articular cartilage. Condensation of subchondral bone has developed adjacent to areas of cartilage erosion, being more marked in the phalanx than in metatarsal bone. An osteophyte extends above the dorsal margin of the metatarsal head. The sesamoid bone of the flexor tendon is seen as an ossicle on the plantar aspect of the joint (Masson trichrome, low power). * There is marked narrowing of the first carpometacarpal joint space, with extensive sclerosis of adjacent bony margins. Osteophyte formation and subchondral cysts are present. Lateral subluxation of the base of the metacarpal bone is a common finding but is not present in this roentgenogram. * Degenerative joint disease: hips, early disease (roentgenogram) The left hip joint demonstrates narrowing with sclerosis and osteophyte formation of adjacent bony margins. There is minimal flattening of the superolateral aspect of the femoral head with reactive bone change. Buttressing of the femoral neck is present medially and laterally as new bone formation w