Abstract Crystal arthropathies of the hand encompass a wide spectrum of disorders characterized by the deposition of various crystals within joints and soft tissues, often leading to inflammatory and degenerative changes. Due to their ability to mimic other rheumatic diseases, accurate diagnosis is challenging and relies heavily on imaging. This review highlights the pathophysiologic features and typical manifestations of key crystal arthropathies—calcium pyrophosphate crystal deposition, gout, hydroxyapatite deposition disease, oxalosis, amyloidosis, and rare mimickers such as ochronosis—focusing on their radiologic appearances. Emphasis is placed on the strengths and limitations of different imaging modalities, particularly radiography, ultrasound, computed tomography, magnetic resonance imaging, and dual-energy computed tomography, in detecting both crystal deposits and associated inflammatory activity. Understanding these imaging patterns is essential for an appropriate differential diagnosis and clinical management.
Diekhoff et al. (2025) studied this question.