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Monosodium urate (MSU) crystals
Intracellular, approximate diameter of neutrophil
Strongly negatively birefringent (yellow)
Calcium pyrophosphate dihydrate (CPPD) crystals
Weakly positively birefringent (blue)
Calcium basic phosphate (CBP) crystals
Small - only identified by electron microscopy
Clumps of crystals (shiny coins) under LM
Alizarin red stain to detect calcium-containing crystals
Acute inflammatory arthritis (young people)
Milwaukee shoulder (older people)
Calcium oxalate crystals
bipyramidal and envelope shaped
Stain with alizarin red
Primary oxaluria (autosomal recessive)
Kidney failure on hemodialysis
Flat and rectangular shaped
Strongly variably birefringent
Polymorphic clumps, rods, or rhomboids
May cause joint pain for several hours
Originate from latex gloves during arthrocentesis
Maltese cross pattern
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