This study evaluated the diagnostic role of ultrasonography in dialysis-rel
ated amyloidosis in shoulders of chronically hemodialyzed patients. Fourtee
n shoulders of 12 long-term hemodialysis patients were examined. All patien
ts had been on dialysis for at least 10 years. All patients had varying deg
rees of pain and limitations of movement in the studied shoulders. Dialysis
-related amyloidosis was the presumed diagnosis in all patients. Any patien
t with a history of any disease, other than dialysis-related amyloidosis, c
apable of producing a pathologic shoulder condition was excluded. The follo
wing parameters were studied: supraspinatus and biceps tendon thickness, te
ndon tears, synovial thickening, and the presence of hypoechoic material ar
ound tendons and within bursae. All shoulders had a nonhomogeneous thickeni
ng, greater than 7 mm, of the supraspinatus tendon. Seven shoulders (50%) h
ad abnormal thickening of the biceps tendon (4 mm or greater), and two shou
lders had abnormal thickening of the subscapularis tendon. Hypoechoic depos
its were seen in the subdeltoid bursae and biceps sheaths in five and six s
houlders, respectively. Three shoulders showed partial tears of the suprasp
inatus tendon, one shoulder showed a tear in the biceps tendon, and one sho
ulder had a tear in the subscapularis tendon, Ultrasonography is an excelle
nt imaging modality in diagnosing the presence of dialysis-related amyloido
sis in symptomatic shoulders of long-term hemodialysis patients, without ha
ving to resort to invasive procedures. The results of previous studies have
been confirmed and new ultrasonographic findings described. Of particular
interest is the involvement of the subscapularis tendon in dialysis-related
amyloidosis. Repeat ultrasonography can become an important way to follow-
up progression of shoulder dialysis-related amyloidosis in hemodialyzed pat
ients.