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Arthritis und Rheuma 2020; 40(06): 408-419
DOI: 10.1055/a-1213-0965
Schwerpunkt

Kristallarthropathien und andere Gelenkerkrankungen durch Ablagerungen

Crystal arthropathy and other deposition induced arthropathies
Inna Frohne∗
1   Poliklinik und Funktionsbereich für Rheumatologie, Heinrich-Heine-Universität Düsseldorf
,
Claudia Dechant∗
2   Sektion Rheumatologie und Klinische Immunologie, Medizinische Klinik IV, LMU Klinikum, München
,
Oliver Sander∗
1   Poliklinik und Funktionsbereich für Rheumatologie, Heinrich-Heine-Universität Düsseldorf
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ZUSAMMENFASSUNG

Durch Kristalle und andere Ablagerungen ausgelöste Arthropathien können sich als Zufallsbefund ohne Symptome, aber auch als akute immobilisierende Arthritis eines oder mehrerer Gelenke manifestieren. Sie treten auch koinzident mit anderen Arthropathien und Arthritiden auf. Typisch sind symptomfreie Intervalle. Aber auch chronisch progrediente Erkrankungsverläufe sind bekannt. Die häufigsten Erkrankungen sind durch CPP- und Urat-Kristalle ausgelöst, andere seltenere Ursachen sind die Hämochromatose, Oxalatarthropathie, Ochronose, Lipid- oder Amyloidoseablagerung. Die durch Ablagerungen ausgelösten Arthropathien können damit auch immer ein Indikator für eine Allgemeinerkrankung sein, welche dann einer ganzheitlichen internistischen Betrachtung bedarf. Die Erkrankungswahrscheinlichkeiten nehmen mit dem Alter zu. Neben der typischen Anamnese und Klinik sind die Bildgebung, hier vor allem Ultraschall und die Dual Energy Computertomografie (DECT), die Labordiagnostik inklusive der Synoviaanalyse essenzielle Bausteine der Diagnostik. Die Therapie ist im akuten Schub symptomatisch, sofern möglich sollte eine gezielte Prophylaxe weiterer Ablagerungen erfolgen.

SUMMARY

Arthropathies triggered by crystals and deposits can manifest themselves as a random finding without symptoms, but also as acute immobilizing arthritis of one or more joints. They also occur co-incidentally with other arthropathies and arthritides. Symptom-free intervals are typical, but chronic progressive disease is also known. The most common causes are CPP and urate crystals, other less frequent causes are hemochromatosis, oxalate arthropathy, ochronosis, lipid or amyloid deposition. The arthropathies triggered by deposits are thus always an indicator of a general disease that requires a holistic internal medicine approach. Prevalence of crystal arthropathies increases with age. In addition to the typical medical history and clinic, imaging, especially ultrasound and dual energy computed tomography, laboratory diagnostics including synovia analysis are essential compounds of the diagnostic work up. The therapy is symptomatic in the acute attacks, if possible a targeted prophylaxis of further deposits should be initiated.

Schlüsselwörter

Kristallarthritis - Chondrokalzinose - CPPD - Gicht - Arthropathie

Keywords

Crystal arthropathy - chondrocalcinosis - CPPD - gout - arthropathy


Publication History

Article published online:
10 December 2020

© 2020. Thieme. All rights reserved.

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