Images in Clinical Medicine
Kim Eagle, M.D., Editor
Cholesterol Crystals
N Engl J Med 1995; 333:1325November 16, 1995
- Article
Figure 1 A 70-year-old man presented with a history of rheumatoid arthritis, insulin-dependent diabetes mellitus, chronic renal insufficiency, and hypertension. He had had rheumatoid arthritis for 17 years, was seropositive for rheumatoid factor, and had destructive arthritis documented by plain radiographs of the hands. His olecranon bursa was chronically swollen but had never been injected with a corticosteroid preparation.
The aspirate of an effusion from the olecranon bursa reveals cholesterol crystals (×400). These crystals are characterized by broad plates with a notched corner, created by their propensity to adhere to one another's surfaces. They are variably and mildly birefringent. The differing colors are due to the rotation of light by the crystals under compensated polarized light microscopy.
Kim Eagle, M.D.
Paul J. DeMarco, M.D.
Richard M. Keating, M.D.
Naval Medical Center, San Diego, CA 92134
