MAGNETIC-RESONANCE-IMAGING OF DIALYSIS-RELATED AMYLOIDOSIS OF THE SHOULDER AND HIP

Objective. The purpose of this study was to evaluate the useful ness o f MRI in identifying abnormalities of the periarticular structures in patients with symptoms of dialysis-related amyloid arthropathy. Design and patients. MR images of shoulders and hips in 5 dialysis patients with symptoms of amyloid arthropathy were compared to images of should ers and hips in 4 asymptomatic dialysis patients, shoulders in 9 nondi alysis patients, and hips in 12 nondialysis patients. These were evalu ated for the presence of focal periarticular osseous lesions, tendinou s and capsular thickening, and periarticular fluid. Results. Increased thickness of the supraspinatus tendon was found in both symptomatic a nd asymptomatic patients. Capsular thickening at the hip was present i n all symptomatic patients, and in 3 of 8 asymptomatic hips. Joint and bursal fluid was common in the symptomatic group, and was present in some asymptomatic individuals. Osseous lesions were detected in the ab sence of plain film findings, and demonstrated variable signal intensi ty. Conclusions. MRI is useful in detecting signs of dialysis-related amyloidosis. Findings of a milder degree in asymptomatic dialysis pati ents suggests that MRI may also be valuable in the early diagnosis of this syndrome.