University of Twente Student Theses


Improving the diagnosis of crystals in synovial fluid by combining Raman spectroscopy with polarization microscopy

Kuipers, Charline (2020) Improving the diagnosis of crystals in synovial fluid by combining Raman spectroscopy with polarization microscopy.

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Abstract:Crystalline arthritides are characterised by the deposition of crystals in synovial fluid (SF). Gout is the most common form and presents itself with the deposition of mono-\\sodium urate crystals. Calcium pyrophosphate dihydrate (CPPD) deposition disease is identified by calcium pyrophosphate crystals in the synovial fluid. Other less common crystals that are found in synovial fluid are calcium oxalate monohydrate and dihydrate, hydroxyapatite, cholesterol and residues of intra-articular corticosteroids which are used to treat symptoms that are caused by crystal deposition. The current method to identify crystals in synovial fluid is compensated polarized light microscopy (CPLM). This technique is often only available in specialised areas and the sensitivity and specificity are affected by user experience. Additionally, not all crystals are equally visible under CPLM due to varying degrees of birefringence. Raman spectroscopy could be a method to improve the identification of crystals because it can provide detailed information about the chemical structure of molecules. In this study, Raman spectroscopy was combined with polarization microscopy to improve the identification of crystals in SF. Additionally, a platform was built to identify newly measured crystals by using a database and correlating the measurements with the database. 195 birefringent objects were measured and 18 Raman spectra were placed in the database for correlation. 101 measurements were correctly identified with varying correlation strengths by using correlation-based crystal identification. Additionally, different sub-types of CPPD were identified and calcium carbonate crystals in the form of calcite and aragonite were possibly found which have rarely been mentioned in literature in combination with SF. The corticosteroid Kenacort was also detected by using the database which is normally challenging to distinguish from CPPD crystals. In conclusion, this study showed that combining Raman spectroscopy with polarization microscopy can provide much new, valuable information. It was also shown that crystal detection is possible by correlating new Raman measurements with a database of known components. Optimisation for different aspects such as data processing and synovial fluid sample preparation are still required but this study has provided a foundation to work toward an improved diagnosis of crystals in SF by combining Raman spectroscopy and polarization microscopy.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:50 technical science in general
Programme:Biomedical Engineering MSc (66226)
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