Osteoarticular disorders of renal origin: disease-related and iatrogenic

Osteoarticular disorders significantly limit the quality of long-term survi val with chronic renal failure, beta 2M amyloidosis is a complication of ch ronic renal failure that has been recognized mostly in patients receiving l ong-term haemodialysis. Patients with beta 2M amyloidosis typically present with the triad of shoulder periarthritis, carpal tunnel syndrome, and flex or tenosynovitis of the hands. Other musculoskeletal manifestations of beta 2M amyloidosis include destructive spondyloarthropathy, cervico-occipital pseudotumours, bone cysts, and pathological fractures. At present. only ren al transplantation may slow or halt the progession of beta 2M amyloidosis, Crystal-induced arthropathy, most commonly caused by basic calcium phosphat e crystals, is an important cause of acute joint inflammation in the patien t with renal failure. The incidence of bone and joint infection is increase d in patients undergoing dialysis. Haemodialysis and peritoneal dialysis ar e also associated with an erosive or destructive arthropathy of finger join ts, which is not explained by local amyloid deposition.