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Volume 355:421-422 July 27, 2006 Number 4
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Medical Mystery: Arthritis — The Answer

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by Jansen, T. L.
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To the Editor: The medical mystery in the June 1 issue1 involved a 51-year-old woman with a 15-year history of rheumatoid arthritis, who presented with swelling and a loss of function of the right shoulder. Microscopy of the synovial fluid drawn from this shoulder showed geometric plates with notched corners, pathognomonic of monohydrate cholesterol crystals (Figure 1A). Analysis of the synovial fluid revealed a leukocyte count of 2100 per cubic millimeter, a total cholesterol level of 7.8 g per liter, a low-density lipoprotein cholesterol level of 6.1 g per liter, a high-density lipoprotein cholesterol level of 1.7 g . . . [Full Text of this Article]



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