AMYLOID ARTHROPATHY OF THE HIP-JOINT - MR DEMONSTRATION OF PRESUMED AMYLOID LESIONS IN 152 PATIENTS WITH LONG-TERM HEMODIALYSIS

The aim of this study was to determine the spectrum MR findings of pre sumed amyloid arthropathy of the hip joints in patients on long-term h emodialysis. We prospectively performed T1- and weighted spin-echo ima ging on 152 consecutive patients on hemodialysis. The duration of hemo dialysis ranged from 5 months to 24 years, 2 months (mean: 8 years, 8 months). The frequency, location, and signal intensity of bone lesions were assessed. In 12 cases with contrast-enhanced MR examination, enh ancement pattern of bone lesions, synovial lesions, and Intra-articula r lesions were characterized. one lesions presumed to be amyloid depos its were identified in 60 patients (39 %). Magnetic resonance raging r evealed that amyloid lesions were more extensive than anticipated by p lain radiographs. All bone lesions showed decreased signal intensity o n weighted images. On T2-weighted images, bone lesions showed increase d signal intensity in 32 patients (54 % ), decreased signal intensity in 11 patients (18 %), and both increased and decreased signal intensi ty in 17 patients (28 %). Following intravenous injection of gadoliniu m-based contrast, all bone lesions showed moderate enhancement. Synovi al thickening could not be identified on T1- and T2-weighted images. H owever, contrast-enhanced images showed thickened synovial membrane, w hich be differentiated from joint fluid. Intra-articular nodules showe d decreased or intermediate signal intensity on T1-weighted images and decreased signal intensity on T2-weighted images; the intra-articular nodules were contiguous with subchondral bone lesions. Magnetic reson ance imaging is useful for evaluating the distribution and extent of a myloidosis of the hip joints in patients undergoing long-term hemodial ysis.