Crystal-associated rheumatic disease. Current management considerations.

Safe, effective treatment is available for acute crystal-associated arthropathy. It is time for some older remedies, phenylbutazone and perhaps colchicine, to give way to more modern regimens of combined NSAID therapy and intra-articular steroid injection. Hypouricaemic agents have revolutionised the management of gout but are not without their dangers, and there is a need for re-emphasis on the value of dietary measures and control of alcohol and diuretic use. At present only symptomatic management is available for chronic pyrophosphate- and hydroxyapatite-associated disease.