In this video from MedCram, Dr. Roger Seheult does a review of the types of crystals that can be found in the urine when looking under a microscope. Dr. Seheult notes that going back for hundreds of years, even in the age of Hippocrates himself, urine was used to make diagnoses.
Cystine crystals
If you were to take a sample of urine and review it under the microscope there are different types of findings that may occur depending on a particular diagnosis. In the case of crystals, you can find crystals that appear to have six sides and are known as cystine crystals. These can come from kidney stones. These types of stones typically don’t show up on x-rays and are known as radiolucent stones as opposed to calcium stones.
Uric Acid crystals
Another type of crystal that can be seen in the urine that has a very needle shaped appearance under polarized light and is referred to as a uric acid crystal. Uric acid is the end product of the metabolism of DNA among other things. Elevated uric acid levels themselves can actually precipitate gouty arthritis or gout attacks. You could also see elevated uric acid levels that result from chemotherapy in leukemia or lymphoma and can lead to an entity called tumor lysis syndrome.
Triple Phosphate crystals
An interesting looking crystal is the triple phosphate crystal that has an appearance of coffin lids. These crystals are typically made out of magnesium, ammonium and phosphate and this is often seen in chronic infections, especially with people that have a bacteria called Proteus Mirabilis. There are stones that can result from this infection. It’s important that you eliminate these stones because by eliminating the stones you also eliminate the infection as the bacteria are typically embedded in the crystals and stones.
Calcium oxalate crystals
This last crystal is calcium oxalate. This looks like a rooftop from homes looking directly down or some think it looks like the Great Pyramid in Egypt. These crystals are not specific but these crystals are classically associated with ethylene glycol. If there is a suspicion of somebody who is trying to commit suicide and they drank an unknown substance such as ethylene glycol (better known as antifreeze) and you find these crystals in the urine, it could provide information on how to properly care for this type of patient.
These findings and a better understanding of urinalysis can be further found in our course of Urinalysis Explained Clearly>a good review of all things urinalysis.
LINKS / REFERENCES:
Urinalysis Explained Clearly (MedCram) | https://www.medcram.com/courses/urina…