{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:37:12Z","timestamp":1753893432214,"version":"3.41.2"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["por-journal.com"],"crossmark-restriction":true},"short-container-title":["Pathol. Oncol. Res."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Apatite rheumatism (AR), chondrocalcinosis (Ch-C), and primary synovial chondromatosis (prSynCh) are regarded as distinct clinical entities. The introduction of the non-staining technique by B\u00e9ly and Ap\u00e1thy (2013) opened a new era in the microscopic diagnosis of crystal induced diseases, allowing the analysis of MSU (monosodium urate monohydrate) HA (calcium hydroxyapatite), CPPD (calcium pyrophosphate dihydrate) crystals, cholesterol, crystalline liquid lipid droplets, and other crystals in unstained sections of conventionally proceeded (aqueous formaldehyde fixed, paraffin-embedded) tissue samples. The aim of this study was to describe the characteristic histology of crystal deposits in AR, Ch-C, and prSynCh with traditional stains and histochemical reactions comparing with unstained tissue sections according to B\u00e9ly and Ap\u00e1thy (2013).<\/jats:p><jats:p><jats:bold>Patients and methods:<\/jats:bold> Tissue samples of 4 with apatite rheumatism (Milwaukee syndrome), 16 with chondrocalcinosis, and 20 with clinically diagnosed primary synovial chondromatosis were analyzed.<\/jats:p><jats:p><jats:bold>Results and conclusion:<\/jats:bold> Apatite rheumatism, chondrocalcinosis, and primary synovial chondromatosis are related metabolic disorders with HA and CPPD depositions. The authors assume that AR and Ch-C are different stages of the same metabolic disorder, which differ from prSynCh in amorphous mineral production, furthermore in the production of chondroid, osteoid and\/or bone. prSynCh is a defective variant of HA and CPPD induced metabolic disorders with reduced mineralization capabilities, where the deficient mineralization is replaced by chondroid and\/or bone formation. The non-staining technique of B\u00e9ly and Ap\u00e1thy proved to be a much more effective method for the demonstration of crystals in metabolic diseases than conventional stains and histochemical reactions.<\/jats:p>","DOI":"10.3389\/pore.2024.1611454","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T10:48:35Z","timestamp":1709635715000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Crystal induced arthropathies\u2014a comparative study of 40 patients with apatite rheumatism, chondrocalcinosis and primary synovial chondromatosis"],"prefix":"10.3389","volume":"30","author":[{"given":"Mikl\u00f3s","family":"B\u00e9ly","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1gnes","family":"Ap\u00e1thy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1556\/OH.2013.29628","article-title":"M\u00f6nckeberg sclerosis \u2013 krist\u00e1ly induk\u00e1lta angiopathia (M\u00f6nckeberg\u201fs sclerosis: crystal-induced angiopathy)","volume":"154","author":"B\u00e9ly","year":"2013","journal-title":"Orvosi Hetilap"},{"key":"B2","first-page":"01","article-title":"Vascular calcification and crystal deposition diseases - a comparative study on 67 amputated legs with atherosclerosis and\/or M\u00f6nckeberg sclerosis","volume":"8","author":"B\u00e9ly","year":"2021","journal-title":"EC Cardiol"},{"key":"B3","article-title":"Fat soluble colorant methods","volume-title":"Histochemistry theoretical and applied. Volume one: p. 129-131, Volume two: analytical technology, Lipids, lipoproteins and proteolipids. Ch. 16, p. 786-849","author":"Pearse","year":"1985"},{"key":"B4","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1136\/ard.53.7.467","article-title":"Submicroscopic crystals in osteoarthritic synovial fluids","volume":"53","author":"Swan","year":"1994","journal-title":"Ann Rheum Dis"},{"key":"B5","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s11926-003-0073-x","article-title":"Calcium pyrophosphate dihydrate and hydroxyapatite crystal deposition in the joint: new developments relevant to the clinician","volume":"5","author":"Pay","year":"2003","journal-title":"Curr Rheumatol Rep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1038\/modpathol.3880394","article-title":"Evaluation of crystals in formalin-fixed, paraffin-embedded tissue sections for the differential diagnosis of pseudogout, gout, and tumoral calcinosis","volume":"14","author":"Shidham","year":"2001","journal-title":"Mod Pathol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"2853","DOI":"10.3899\/jrheum.090163","article-title":"Positive alizarin red clumps in Milwaukee shoulder syndrome","volume":"36","author":"Forster","year":"2009","journal-title":"J Rheumatol"},{"key":"B8","first-page":"46","article-title":"\u201cMicroscopic findings under compensated polarized light and phase light\u201d in: gatter RA","volume-title":"A practical handbook of joint synovial fluid analysis","author":"Gatter","year":"1991"},{"key":"B9","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1002\/art.1780260211","article-title":"Alizarin red S staining as a screening test to detect calcium compounds in synovial fluid","volume":"26","author":"Paul","year":"1983","journal-title":"Arthritis Rheum"},{"key":"B10","first-page":"201","article-title":"Alizarin red S staining of calcium compound crystals in synovial fluid","volume":"67","author":"Shoji","year":"1993","journal-title":"Nihon Seikeigeka Gakkai Zasshi"},{"key":"B11","doi-asserted-by":"publisher","first-page":"569","DOI":"10.4103\/0019-5413.87139","article-title":"Hydroxyapatite crystal deposition causing rapidly destructive arthropathy of the hip joint","volume":"45","author":"Yang","year":"2011","journal-title":"Indian J Orthopaedics"},{"key":"B12","unstructured":"A simple method of diagnostic pathology for identification of crystal deposits in metabolic and crystal induced diseases\n            B\u00e9lyM\n            Ap\u00e1thy\u00c1\n          2022"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.23937\/cabjd-2017\/1710007","article-title":"Metabolic diseases and crystal induced arthropathies technic of non-staining histologic sections - a comparative study of standard stains and histochemical reactions","volume":"1","author":"B\u00e9ly","year":"2018","journal-title":"Clin Arch Bone Jt Dis"},{"key":"B14","first-page":"018","article-title":"Crystal deposits in tissue of patients with chondrocalcinosis and apatite rheumatism \u2013 microscopic identification of CPPD and HA with the non-staining technique of Bely and Ap\u00e1thy","volume":"4","author":"B\u00e9ly","year":"2018","journal-title":"BAOJ Clin Trials"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1857","DOI":"10.1136\/annrheumdis-2023-eular.193","article-title":"AB1262\u2005amorphous mineralization, chondroid and\/or osteoid formation in crystal induced metabolic disorders \u2013 a comparative study of apatite rheumatism, chondrocalcinosis and primary synovial chondromatosis apatite rheumatism, chondrocalcinosis, primary synovial chondromatosis","volume":"82","author":"Ap\u00e1thy","year":"2023","journal-title":"Ann Rheum Dis"},{"key":"B16","first-page":"01","article-title":"A comparative microscopic study of apatite rheumatism, chondrocalcinosis and synovial chondromatosis \u2013 HA and CPPD induced metabolic disorders","volume":"12","author":"B\u00e9ly","year":"2023","journal-title":"EC Pulmonology Respir Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1136\/ard.60.1.80","article-title":"Preservation of calcium pyrophosphate dihydrate crystals: effect of Mayer's haematoxylin staining period","volume":"60","author":"Ohira","year":"2001","journal-title":"Ann Rheum Dis"},{"key":"B18","first-page":"100","article-title":"\u201cMayer\u2019s hematoxylin\u201d In: carson FL","volume-title":"Histotechnology","author":"Carson","year":"1990"},{"key":"B19","first-page":"55","article-title":"Methods of general utility for the routine study of tissues, sodium Alizarin sulfonate stain for calcium and Von Kossa\u2019s method for phosphates and carbonates","volume-title":"Staining methods, histologic and histochemical","author":"McManus","year":"1960"},{"key":"B20","first-page":"333","article-title":"Alizarin red S","volume-title":"Laboratory manual of histochemistry","author":"Vacca","year":"1985"},{"key":"B21","first-page":"264","article-title":"Von K\u00f3ssa\u2019s method","volume-title":"Histpathologic technic and practical histochemistry","author":"Lillie","year":"1954"},{"key":"B22","first-page":"227","article-title":"\u201cStatistical methods\u201d volume 2","volume-title":"Geigy scientific tables","author":"Lentner","year":"1982"},{"key":"B23","first-page":"66","article-title":"Metabolikus megbeteged\u00e9sek \u2013 a krist\u00e1lyok csod\u00e1latos vil\u00e1ga (Metabolic disorders \u2013 the wonderful world of crystals)","volume":"9","author":"B\u00e9ly","year":"2023","journal-title":"Orvostov\u00e1bbk\u00e9pz\u0151 Szemle"},{"key":"B24","first-page":"03","article-title":"Crystal deposits in apatite rheumatism and chondrocalcinosis \u2013 microscopic identification of hydroxyapatite and calcium pyrophosphate dihydrate crystals with standard stains and histochemical reactions and with the nonstaining technique of B\u00e9ly and Ap\u00e1thy","volume":"1","author":"B\u00e9ly","year":"2022","journal-title":"EC Pulmonology"},{"key":"B25","first-page":"1","article-title":"Apatite rheumatism and chondrocalcinosis are different stages of the same metabolic disorder \u2013 a clinicopathologic study of 21 patients with clinically diagnosed apatite rheumatism or chondrocalcinosis","volume":"10","author":"B\u00e9ly","year":"2022","journal-title":"J Interdiscip Histopathology"},{"key":"B26","unstructured":"Hydroxyapatite crystal-induced rheumatology\n            ReginatoAM\n            YuviencoC\n          2022"},{"key":"B27","first-page":"193","article-title":"Kalziumpirophosphat-arthropathie, apatitkrankheiten, prim\u00e4re synoviale osteochondromatose","volume-title":"Gelenkpathologie, historische Grundlagen, Ursachen und Entwicklungen von Gelenkleiden und ihre Pathomorphologie","author":"Mohr","year":"2000"},{"key":"B28","first-page":"1377","article-title":"Diseases associated with deposition of calcium pyrophosphate or hydroxyapatite","volume-title":"Crystal-associated synovitis, section XV, kelly\u2019s textbook of rheumatology","author":"Reginato","year":"2001"},{"key":"B29","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1136\/ard.22.3.142","article-title":"Chondrocalcinosis articularis Section L clinical and radiological study","volume":"22","author":"\u017dit\u0148an","year":"1963","journal-title":"Ann Rheum Dis"},{"key":"B30","first-page":"984","article-title":"Metabolic, nutritional and endocrine diseases of connective tissue, synovial osteochondromatosis","volume-title":"Pathological basis of the connective tissue diseases","author":"Gardner","year":"1992"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1002\/art.1780261008","article-title":"Crystal populations in human synovial fluid. Identification of apatite, octacalcium phosphate, and tricalcium phosphate","volume":"26","author":"McCarty","year":"1983","journal-title":"Arthritis Rheum"},{"key":"B32","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/978-3-662-04819-1_17","volume-title":"Crystal-associated arthropathies\u201d in Pathology and pathobiology of rheumatic diseases","author":"Fassbender","year":"2002"},{"key":"B33","first-page":"5","article-title":"Crystal induced arthritis: an overview. INJR (Indian Journal of Rheumatology - formerly)","volume":"10","author":"Gupta","year":"2002","journal-title":"J Indian Rheumatol Assoc"},{"key":"B34","doi-asserted-by":"publisher","first-page":"2575","DOI":"10.1056\/NEJMra1511117","article-title":"Calcium pyrophosphate deposition disease","volume":"374","author":"Rosenthal","year":"2016","journal-title":"New Engl J Med"},{"key":"B35","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1016\/S0140-6736(76)91400-8","article-title":"Apatite deposition disease. A new arthropathy","volume":"307","author":"Dieppe","year":"1976","journal-title":"Lancet"},{"key":"B36","doi-asserted-by":"publisher","first-page":"1488","DOI":"10.1136\/bmj.283.6305.1488","article-title":"Milwaukee shoulder","volume":"283","author":"Dieppe","year":"1981","journal-title":"Br Med J (Clin Res Ed)."},{"volume-title":"Clinical manifestations and diagnosis of calcium pyrophosphate crystal deposition (CPPD) disease\u201d","year":"2024","author":"Rosenthal","key":"B37"},{"key":"B38","first-page":"108","article-title":"\u201cCalcium pyrophosphate dihydrate crystal deposition disease\u201d and \u201cCalcium hydroxyapatite crystal deposition disease\u201d","volume-title":"Radiological atlas of rheumatological diseases","author":"Bachmann","year":"1994"},{"volume-title":"Pseudogout","year":"2022","key":"B39"},{"key":"B40","first-page":"572","article-title":"Krist\u00e1lyatrthritisek","volume-title":"Reumatol\u00f3gia","author":"P\u00e1link\u00e1s","year":"2019"},{"key":"B41","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1136\/ard.31.3.219-b","article-title":"Calcium pyrophosphate deposits in synovial membrane","volume":"31","author":"Bywaters","year":"1972","journal-title":"Ann Rheum Dis"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1148\/radiographics.10.6.2175444","article-title":"Calcium hydroxyapatite deposition disease","volume":"10","author":"Hayes","year":"1990","journal-title":"RadioGraphics"},{"key":"B43","first-page":"1733","article-title":"Calcium hydroxyapatite crystal deposition disease","volume-title":"Diagnosis of bone and joint disorders","author":"Resnick","year":"1988"},{"volume-title":"Synovial chondromatosis \u2013 gard","year":"2023","key":"B44"},{"volume-title":"Synovial chondromatosis - OrthoInfo \u2013 AAOS","year":"2022","key":"B45"},{"key":"B46","first-page":"49","article-title":"Generalized secondary amyloidosis in rheumatoid arthritis","volume":"40","author":"Bely","year":"1992","journal-title":"Acta morphologica Hungarica"},{"key":"B47","first-page":"177","article-title":"\u201cIdentification of amyloid deposits by histochemical methods of romh\u00e1nyi\u201d in: b\u00e9ly M, guest editor","author":"B\u00e9ly","year":"2001","journal-title":"Amyloid"},{"key":"B48","first-page":"1","volume-title":"Clinical pathology of rheumatoid arthritis: cause of death, lethal complications and associated diseases in rheumatoid arthritis","author":"B\u00e9ly","year":"2012"},{"key":"B49","first-page":"444","article-title":"Formal pathogenesis of systemic and localized amyloidosis","volume":"6","author":"B\u00e9ly","year":"2019","journal-title":"EC Cardiol"},{"volume-title":"Sequential analysis","year":"1947","author":"Wald","key":"B50"},{"key":"B51","doi-asserted-by":"publisher","first-page":"183","DOI":"10.5435\/00124635-199707000-00001","article-title":"Calcific tendinopathy of the rotator cuff: pathogenesis, diagnosis, and management","volume":"5","author":"Uhthoff","year":"1997","journal-title":"J Am Acad Orthopaedic Surgeons"}],"container-title":["Pathology and Oncology Research"],"original-title":[],"link":[{"URL":"https:\/\/www.por-journal.com\/articles\/10.3389\/pore.2024.1611454\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T10:49:01Z","timestamp":1709635741000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.por-journal.com\/articles\/10.3389\/pore.2024.1611454\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,5]]},"references-count":51,"alternative-id":["10.3389\/pore.2024.1611454"],"URL":"https:\/\/doi.org\/10.3389\/pore.2024.1611454","relation":{},"ISSN":["1532-2807"],"issn-type":[{"type":"electronic","value":"1532-2807"}],"subject":[],"published":{"date-parts":[[2024,3,5]]},"article-number":"1611454"}}