Urinary Crystals Pictures

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URINARY CRYSTALS UNDER MICROSCOPE

Transcribed by: Dianne Nolasco

Normal Crystals in ACID urine (CAHUNC)


Calcium Sulfate
 Cigarrete butt appearance (pinagupusan ng sigarilyo)

Amorphous Urates
 Appears brick dust yellow-brown granules/precipitates

Figure 1. Dihydrate CaOx

Normal crystals in ALKALINE urine (CATAC)


Calcium Phosphate
 colorless, flat rectangular plates, thin prisms
 rosette formations which may be confused with sulfonamide
Hippuric acid crystals
 Appear pointed but they usually appear in singles
 Not clinically significant

Uric acid (Monosodium Urates)


 Seen in variety of shapes: rhombic, four-sided flat plates (whet
stones), wedges and rosettes, barrel-shaped/lemon-shaped crystals,
may also have six-sided hexagonal shape similar to cystine ‼
 Yellow brown in color

Amorphous Phosphates
 White or colorless granules; lalo na pag na-refrigerate na

Na Urates and Acid Urates


 Acid urates appear as large granules with spicules
 Sodium urates appear as needle-shaped and are seen in synovial fluid
during episodes of gout
 If seen in urine, they appear slender prisms in fan-like manner and are
called peacock-tail crystals

Triple Phosphate
 aka ammonium magnesium phosphate/struvite crystals
 colorless prism that resembles like coffin-lid

Calcium Oxalate
o Dihydrate calcium oxalate (weddellite crystals)
 Colorless, octahedral, mukang envelope
 Two pyramids joined at their bases
o Monohydrate calcium oxalate (whewhellite crystals)
 Oval or dumbbell shaped
Ammonium Biurate Tyrosine
 yellow brown crystal with characteristic of thorny apples (spicule  Colorless to yellow needles that forms clumps or rosettes
covered spheres)  Mukang walis

Leucine
 Yellow brown spheres that demonstrate concentric circles with radial
striations; Scallop-lily crystal
Calcium Carbonate
 colorless dumbbell/spherical shape crystals
 may appear in clumps that resembles amorphous materials
 napapagkamalang yeast cells

Bilirubin crystals
 Appear as clumped needles or granules with characteristic dark
yellow color of bilirubin
 Should be accompanied with positive chemical test for bilirubin

Abnormal Crystals in Urine


Manner of reporting: average and reported/lpf
Cystine
 Hexagonal plates; colorless and could be thick or thin
 Difficult to distinguish from uric acid

Miscellaneous/Iatrogenic Crystals
Sulfonamide Crystals
 Rhombic, needles, whetstones, sheaves of wheat, rosettes ranging
from colorless to yellow brown (may resemble calcium phosphate)

Cholesterol crystals
 Rectangular plates with notch in one or more corners
 Staircase pattern/stair step crystals/notched crystals

Ampicillin crystals
 Colorless needles in bundles AFTER REFRIGERATION

Radiographic dye crystals


 Similar to cholesterol crystal and are also highly birefringent
 Blunt or smooth ang end kaysa kay cholesterol crystal

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