Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 18;12(5):1260.
doi: 10.3390/diagnostics12051260.

Assessment of Crystals in the Synovial Fluid of Psoriatic Arthritis Patients in Relation to Disease Activity

Mariela Geneva-Popova  1 , Stanislava Popova-Belova  1 , Velicka Popova  2 , Nikolay Stoilov  3
Affiliations

Assessment of Crystals in the Synovial Fluid of Psoriatic Arthritis Patients in Relation to Disease Activity

Mariela Geneva-Popova et al. Diagnostics (Basel). .

Abstract

Background: This study examines the relationship between the presence of crystals in the synovial fluid of patients with psoriatic arthritis (PsA) and disease activity. Methods: The synovial fluid of 156 PsA patients was analyzed and compared to 50 patients with gonarthrosis (GoA). The Leica DM4500P polarization microscope was used for crystal detection. Results: The presence of crystals was observed in 23.71% of PsA patients and none of the GoA patients, p < 0.001. Monosodium urate crystals (67.58%) and calcium pyrophosphate crystals (21.62%) were prevalent. The presence of crystals in the synovial fluid of PsA patients was associated with high disease activity according to the Composite Psoriatic Disease Activity Index (OR = 18.75, 95%; CI: 7.13 to 49.25) and the Disease Activity for Psoriatic Arthritis (OR = 15.96, 95%; CI: 5.76 to 44.23), with severe disability according to the Health Assessment Questionnaire Disability Index (OR = 13.60, 95%; CI: 5.09 to 36.31), and with severe pain on the Visual Analog Scale (OR = 157.25, 95%; CI: 39.50 to 625.94). Conclusion: Our results suggest that synovial fluid examination should be included in the treatment pathway for PsA patients with active disease, to aid in determining whether urate-lowering therapy is required.

Keywords: biomarkers; disease activity indices; psoriatic arthritis; synovial fluid crystals.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Odds ratios and 95% CIs showing the relation between the presence of crystals in the synovial fluid of the PsA patients and the chance of severe and unbearable pain (VAS), high disease activity (mCPDAI and DAPSA), and severe disability (HAQ).
See this image and copyright information in PMC

References

    1. Alamanos Y., Voulgari P.V., Drosos A.A. Incidence and prevalence of psoriatic arthritis: A systematic review. J. Rheumatol. 2008;35:1354–1358. - PubMed
    1. Augustin M., Vietri J., Tian H., Gilloteau I. Incremental burden of cardiovascular comorbidity and psoriatic arthritis among adults with moderate-to-severe psoriasis in five European countries. J. Eur. Acad. Dermatol. Venereol. 2017;31:1316–1323. doi: 10.1111/jdv.14286. - DOI - PubMed
    1. Arevalo A.B., Haddadin F., Contreras G., Murray S., Luo Y., Ali Y. Cardiovascular impact of hyperuricemia in patients with psoriatic arthritis. Ann. Rheum. Dis. 2019;78:1268.
    1. Perez-Chada L.M., Merola J.F. Comorbidities associated with psoriatic arthritis: Review and update. Clin. Immunol. 2020;214:108397. doi: 10.1016/j.clim.2020.108397. - DOI - PubMed
    1. Tripolino C., Ciaffi J., Ruscitti P., Giacomelli R., Meliconi R., Ursini F. Hyperuricemia in Psoriatic Arthritis: Epidemiology, Pathophysiology, and Clinical Implications. Front. Med. 2021;8:737573. doi: 10.3389/fmed.2021.737573. - DOI - PMC - PubMed