URINALYSIS
1
UA Crystals
3
4
5
6
Brown or
colorless
granules
Na or K
Sediment in
spin down
tube may
have brick
red color
Amorphous Urates
7
• Ca or Mg
• Found in Basic
urine
• Dissolves in
Acetic Acid
Amorphous Phosphates
8
Acid urine
Yellowish Brown
Ovals with pointed
Ends
Uric Acid
9
Yellowish
Brown
Ovals with
pointed
Ends
Uric Acid
10
Birefringence
under
polarized light
Uric Acid
11
Sometimes
associated with
gout
Uric Acid
12
Uric Acid Polarized
13
Many Forms
“Great
Imposters”
Uric Acid Rosette Form
14
• Common
• pH acid or neutral
• Envelope or dumb
bell shaped
• Oval May be
mistaken for RBC
• Ca Ox soluble in
HCl Insoluble in
acetic acid
• RBC lyse in acetic
acid
Calcium Oxalate
15
Calcium Oxalate and Epi
16
Calcium Oxalate
17
Calcium oxalate dihydrate and
monohydrate (dumbbell and ring
forms) - x400 magnification.
18
Calcium oxalate dihydrate,
various octahedral forms...
19
Calcium Oxalate
20
Coffin Lid
Triple Phosphate
21
AKA Ammonium
Magnesium Phosphate
Found in Basic or
Neutral urine
Soluble in Acetic Acid
Triple Phosphate
22
Alkaline urine
Irregular plates
“Sheets of Ice”
Rosetts
Associated with Cystitis
and Urine retention
Calcium Phosphate Crystals
23
Alkaline urine
Irregular plates
“Sheets of Ice”
Rosettes
Associated with Cystitis
and Urine retention
Calcium Phosphate Crystals
24
Alkaline urine
Irregular plates
“Sheets of Ice”
Rosettes
Associated with Cystitis
and Urine retention
Calcium Phosphate Crystals
25
Alkaline urine
Spheres or Dumbbell forms
Birefringent
Calcium Carbonate Crystals
26
• Rhombohedral
form
Calcium Carbonate
27
• Dumbbell form
Calcium Carbonate
28
Alkaline urine
Only urate found
in alkaline urine
Yellow brown
spheres with
horns
Thorn apple
Soluble in Acetic
Acid
Ammonium Biurate Crystals
29
Ammonium Biurate
30
• pH alkaline
• Thorn apple
Ammonium Biurate
31
• All are found in acidic urine
• Indicate pathologic condition
Abnormal Crystals
32
Acid pH
Needle shaped
fine and silky
appearance
Liver disease due
to hepatitis,
hepatocellular
poisons
Leukemia's
Typhoid fever and
smallpox
Tyrosine
33
Acid pH
Needle shaped
fine and silky
appearance
Liver disease due
to hepatitis,
hepatocellular
poisons
Leukemia's
Typhoid fever and
smallpox
Tyrosine
34
Acid pH
Spheres, Yellowbrown concentric
rings
Birefringence
Pseudo Maltese
Cross
Maple syrup
disease
Liver Disease
Leucine
35
Acid pH
Spheres, Yellowbrown concentric
rings
Birefringence
Pseudo Maltese
Cross
Maple syrup
disease
Liver Disease
Leucine
36
Acid pH
Thin colorless
hexagonal plates
Birefringent in
polarized light
Hereditary
metabolic
disorders
involving renal
transport of
various amino
acieds
Cystine
37
Acid pH
Thin colorless
hexagonal plates
Birefringent in
polarized light
Hereditary
metabolic
disorders
involving renal
transport of
various amino
acieds
Cystine
38
Acid pH
Thin colorless
hexagonal plates
Birefringent in
polarized light
Hereditary
metabolic
disorders
involving renal
transport of
various amino
acids
Cystine
39
Cystine
40
• Acid Urine
Cystine
41
Acid Urine
Regular or irregular
plate with Notched
corner
Birefringent under
polarized light
Various renal
diseases
Nephrotic Syndrome
or other condition
where there is a
deposition of lipids
in Kidney
Cholesterol
42
Acid Urine
Regular or irregular
plate with Notched
corner
Birefringent under
polarized light
Various renal
diseases
Nephrotic Syndrome
or other condition
where there is a
deposition of lipids
in Kidney
Cholesterol
43
Cholesterol
44
Oval Fat Bodies
45
Oval Fat Bodies Polarized
46
Fiber
47
Fatty Cast Polarized
48
Corpora amylacea
49
• Sterheimer
Malbin Stain
Crystalline Artifact
50
• Acidic Urine
• Pigmented
yellowish Brown
Granules
• Pathologic appear
in a wide variety of
hepatobiliary and
hematopoietic
diseases
Bilirubin Crystals
51
• Acidic Urine
• Pigmented
yellowish Brown
Granules
• Pathologic appear
in a wide variety of
hepatobiliary and
hematopoietic
diseases
Bilirubin Crystals
52