Middle children generally show more investment in control over external reality through the acquisition of knowledge and competence: where they do have worries, these may be more a fear of kidnappings, rapes, and scary media events, as opposed to fantasy things (e.g., witches, monsters, ghosts). Preadolescents may well view human relationships differently (e.g. they may notice the flawed, human side of authority figures). Alongside that, they may begin to develop a sense of self-identity, and to have increased feelings of independence: may feel an individual, no longer "just one of the family." A different view on morality can emerge; and the middle child will also show more cooperativeness. The ability to balance ones own needs with those of others in group activities. Many preadolescents will often start to question their home life and surroundings around this time and they may also start to form opinions that may differ from their upbringing in regards to issues such as politics, religion, sexuality, and gender roles. Greater responsibility within the family can also appear, as middle children become responsible for younger siblings and relatives, as with babysitting; while preadolescents may start caring about what they look like and what they are wearing. Prior to adolescence, children may have a dependence on their family as their main agent of socialization. This helps the child establish their attitudes, viewpoints, social norms, and societal roles.Among these changes is the shift from elementary to middle (or junior high) school.
Crystal arthropathy is a class of joint disorder (called arthropathy) that is characterized by accumulation of tiny crystals in one or more joints. Polarizing microscopy and application of other crystallographic techniques have improved identification of different microcrystals including monosodium urate, calcium pyrophosphate dihydrate, calcium hydroxyapatite, and calcium oxalate. Types
Causes
Deposition of crystals in joints
Calcium pyrophosphate dihydrate crystal formation:
Increased production of inorganic pyrophosphate
Decreased levels of pyrophosphatase in cartilage
Decreased levels of cartilage glycosaminoglycans
Hyperparathyroidism
Hemochromatosis
Hypophosphatasia
Hypomagnesemia
Hydroxyapatite deposition:
Tissue damage
Hyperparathyroidism
Hypercalcemia
Hyperphosphatemia
Calcium oxalate deposition:
Enhanced production of oxalic acid due to enzyme defect
Poor excretion of oxalic acid in kidney failure
Excessive ascorbic acid intake in kidney failure

Risk factors
Obesity
Kidney failure
Hyperphosphatemia
Hyperparathyroidism
Hypercalcemia
Tissue damage (dystrophic calcification)

Diagnosis
Differential diagnosis
Septic arthritis
Type IIa hyperlipoproteinemia
Amyloidosis
Multicentric reticulohistiocytosis
Hyperparathyroidism
Spondyloarthropathy
Rheumatoid arthritis
Fibromyalgia

Treatment
References


== External links ==