Metabolism of crystals within the joint.

@article{Oliviero2012MetabolismOC,
  title={Metabolism of crystals within the joint.},
  author={Francesca Oliviero and A. Scanu and Leonardo Punzi},
  journal={Reumatismo},
  year={2012},
  volume={63 4},
  pages={
          221-9
        }
}
Monosodium urate (MSU), calcium pyrophosphate dihydrate (CPPD) and basic calcium phosphate (BCP) crystals deposit in joints and surrounding tissues causing acute inflammation and chronic cartilage damage. A number of endogenous substances and physicochemical conditions affect their precipitation, growth and even dissolution, regulating their metabolism and inflammatory activity. We review how MSU and calcium crystals form within the joints and the various factor which regulate their formation. 
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Different proteins and factors within connective tissues may promote MSU crystalsization and may be important for determining the sites at which MSU crystallization occurs in the presence of elevated urate concentrations.
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This review reports the most relevant findings detectable by ultrasound and the current available data in the literature regarding the role of musculoskeletal ultrasound in gout.
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Findings suggest that a role of NETs in crystal-induced arthritis is to "trap extracellular particles", including microcrystals, may be the basis of tophi and CPPD deposition and may have implications for disease evolution, rather than for spontaneous resolution of the acute attack.
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The combination treatment therapy resulted in effective treatment of gout due to degradation of crystals and anti-inflammatory response, and the developed nanoparticles formulations displayed zero order and Higuchi release kinetics with non-Fickian diffusion.
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