Radiological Features of Dialysis Amyloid Spondyloarthropathy

Fiocchi, O; Pl, Bedani; Orzincolo, C; Storari, Alda; Pl, Cavazzini; Malacarne, F; Farinelli, A

doi:10.1177/039139888901200403

Cited by 26 publications

(18 citation statements)

References 13 publications

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“…A chronic arthropathy that predominantly involves the shoulders and is frequently associated with amyloid carpal tunnel syndrome (CTS), subchondral bone cysts or erosions, and destructive arthropathies has recently been described in such patients (2). The cervical spine is frequently involved in this erosive process, and there are numerous reports of a destructive spondylarthropathy of the cervical spine (3)(4)(5)(6)(7)(8)(9)(10). However, the craniovertebral junction has not been extensively investigated, despite the risk of severe neurologic complications associated with lesions at this site.…”

mentioning

confidence: 99%

Pseudotumor of the craniocervical junction during long‐term hemodialysis

Rousselin

Hélénon

Zingraff

et al. 1990

Arthritis & Rheumatism

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A systematic study of the upper cervical spine was performed using magnetic resonance imaging in 25 patients (15 men and 10 women) who had been undergoing hemodialysis for more than 10 years. Seven pseudotumors of the periodontoid soft tissue were disclosed, which were similar to the pannus recently described in rheumatoid arthritis. Bone cystic radiolucencies were observed in association with these pseudotumors in 5 patients. The radiolucencies were located in the atlas (1 in the lateral mass and 1 in the anterior branch) and in the axis (3 in the odontoid process and 1 in the vertebral body). No horizontal or vertical atlantoaxial subluxation was demonstrated. These features were observed only in patients who had amyloid arthropathy. They could be a frequent, yet thus far little-recognized, feature of pZmicroglobulin amyloidosis.Patients with end-stage renal failure who are receiving long-term hemodialysis may develop a variety of osteoarticular abnormalities, which increase in frequency with the duration of dialysis therapy. Many

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mentioning

confidence: 99%

Pseudotumor of the craniocervical junction during long‐term hemodialysis

Rousselin

Hélénon

Zingraff

et al. 1990

Arthritis & Rheumatism

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“…Fiocchi et al [3] reported 18.0% (9 of 50 patients) and Leone et al [8] reported 19.4% (6 of 31 patients). In our study [20], the incidence of DSA was 20.8% (123 of 616 patients) and almost corresponded to the former studies.…”

Section: Discussionmentioning

confidence: 97%

“…The pathogenesis and natural history of DSA are still not fully understood, but it is a well-known amyloidosis, which consists of b2-microglobulin and plays an important role in the development of DSA [2,3,[15][16][17].…”

Section: Introductionmentioning

confidence: 99%

The relationship between the type of destructive spondyloarthropathy and its 10 years ago cervical spine alignment

et al. 2009

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The objective of this retrospective study was to analyze the relationship between the type of destructive spondyloarthropathy (DSA) and its 10 years ago cervical spine alignment. DSA was reported as a serious complication of long-term hemodialysis. Although previous reports in regard to risk factor of DSA dealt with the period of hemodialysis and the patient's age upon commencement of hemodialysis, we could not find any reports of the relationship between the type of DSA and its 10 years ago cervical spine alignment. In 96 DSA patients who were the subjects of our study, 8 patients were defined as stage 1, 39 patients as stage 2, 5 patients as stage 3 type A, 11 patients as stage 3 type B, and 33 patients as stage 3 type D. The C2/ C7 angle of stage 3 type B was statistically low. The number of the abnormal local cervical alignment was larger in stage 3 types A and B. Multivariate analysis revealed that the risk factors of stage 3 types A and B were the C2/C7 angle and the existence of local abnormal alignment. Fifty-four patients were symptomatic due to DSA and treated at our hospital. Forty-four patients were treated conservatively with medications, physiotherapy, or wearing cervical brace. Ten patients underwent surgical treatment. The loss of physiological lordosis of cervical spine promoted the progression of DSA. Furthermore, the number of the abnormalities of local cervical alignment was statistically larger in stage 3 types A and B; they were the crucial factor promoting the progression of DSA stage 3 types A and B.

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“…It has also been pro-(small arrows), displacing the pharyngeal air. chi and colleagues (10). Reports of an associated fracture of the dens and quadriplegia secondary to extradural compression by Pzm demonstrate the serious nature of this process (13).…”

Section: Discussionmentioning

confidence: 99%

Radiologic vignette

1991

Arthritis & Rheumatism

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The patient is a 68-year-old man with end-stage renal disease, in whom kidney transplantation had been unsuccessful. He had been receiving hemodialysis for 20 years. He had had a carpal tunnel release and now presents with increasing pain and swelling in the shoulders, wrists, knees, and hips.Well-defined erosion of the femoral neck with preservation of the femoral head suggests the presence Radiologic findingsAn anteroposterior view of the pelvis (Figure 1) shows multiple surgical clips, generalized osteopenia, and vascular calcifications. These findings are consistent with the patient's history of chronic renal failure and transplantation. In addition, there are prominent erosions of the femoral necks bilaterally, with good preservation of the hip cartilage. A well-defined left acetabular lucent lesion is present (Figure 2).

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Radiological Features of Dialysis Amyloid Spondyloarthropathy

Cited by 26 publications

References 13 publications

Pseudotumor of the craniocervical junction during long‐term hemodialysis

Pseudotumor of the craniocervical junction during long‐term hemodialysis

The relationship between the type of destructive spondyloarthropathy and its 10 years ago cervical spine alignment

Radiologic vignette

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