MAGNETIC-RESONANCE-IMAGING FINDINGS IN SHOULDERS OF HEMODIALYZED PATIENTS

Twenty two patients (24 shoulders) who had undergone hemodialysis for a mean of 13.4 years, and who had reported chronic shoulder pain for > 6 months, were examined by magnetic resonance imaging (MRI), including T1 and T2 echo gradient images in the frontal plane and T1 images aft er gadolinium. An increase in thickness of the rotator cuff as well as synovitis and bursitis were documented. Twenty shoulders demonstrated a mean thickness of 8.05 mm. Most often, the signal intensity of T2 a nd T1 weighted images was intermediate, and T1 images failed to show a n uptake of gadolinium. Of the 24 shoulders, 20 had subacromial subdel toid bursitis and 21 had glenohumeral synovitis. These results indicat e that MRI is of help in the early diagnosis of arthropathy in long te rm hemodialyzed patients. Magnetic resonance imaging findings are more precise than those of ultrasound, particularly for thickness measurem ents. Moreover, MRI films are easier to read and permit the detection of synovial involvements. The therapeutic value of MRI lies in the fac t that it can isolate the two principal causes of shoulder pain in hem odialyzed patients. The increase in cuff thickness leading to impingem ent syndrome can be treated by surgical decompression; the synovitis c an be treated by radioisotope synovectomy.