Positive birefringent crystals and pseudogout

A clinician identifies these crystals by examining fluid removed from an affected joint under polarized light. The crystals can trigger sudden inflammation, often causing pain, warmth, tenderness, and swelling. The finding supports pseudogout, but your symptoms, examination, and other fluid results still matter. It is different from the needle-shaped crystals associated with gout.

Pseudogout can affect a knee, wrist, ankle, or another joint. An attack may begin abruptly and settle gradually, while crystal deposits can remain between attacks. Read more about [Pseudogout](/conditions/pseudogout/) and [Joint Swelling](/symptoms/joint-swelling/).

Follow the treatment plan given for the current flare and avoid repeatedly stressing the painful joint while it is inflamed. A clinician may discuss an [Anti-Inflammatory Medication](/treatments/non-surgical-orthopedics/anti-inflammatory-medication/) or, when suitable, a [Cortisone Injection](/treatments/non-surgical-orthopedics/cortisone-injection/). A [Joint Aspiration](/treatments/non-surgical-orthopedics/joint-aspiration/) may both test the fluid and reduce pressure when a large effusion is present.

Keep a record of when attacks begin, which joint is involved, fever or skin changes, and how treatment affects you. Do not start or stop prescription medicine without checking the prescriber, particularly if you have kidney, stomach, heart, or bleeding concerns.

Arrange prompt medical assessment for a newly hot, swollen, very painful joint, especially if you feel feverish or unwell. Crystal arthritis can resemble a joint infection, and the distinction may require examination and fluid testing. Seek urgent help if severe pain develops quickly, you cannot use the limb, or you become faint or confused.

Ask which crystals were seen, whether the fluid was checked for infection, and what the result means alongside your examination. Clarify which medicine is appropriate for your health conditions, how to use it during a flare, and whether recurrent attacks need a prevention plan.