Bone cysts and haemodialysis-related amyloidosis.
Carpal tunnel syndrome and arthropathy are frequent complications of long-term haemodialysis. Both are associated with cystic lesions of bone and are related to synovioarticular deposition of a new type of amyloid derived from circulating beta 2-microglobulin. Retrospective analysis of the radiographic skeletal surveys of all 58 patients on haemodialysis for 6 or more years revealed one or more cystic bone lesions in 36% of patients. Radiographic analysis indicated that a number of these cysts were due to hyperparathyroid bone disease or joint degeneration, but a majority showed features suggesting an arthropathy of another aetiology. We present evidence that the development of these latter cysts in an individual on long-term dialysis is an indicator of the presence of synovioarticular amyloidosis of the beta 2-microglobulin type. The radiographic characteristics and development of these cysts, which we believe are due to bony infiltration from synovioarticular amyloid are described.
Sargent
M A
MA
Department of Diagnostic Radiology, Withington Hospital, South Manchester, UK.
Fleming
S J
SJ
Chattopadhyay
C
C
Ackrill
P
P
Sambrook
P
P
D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000000981:diagnostic imaging* / Q000209:etiology; D001845:Bone Cysts / Q000000981:diagnostic imaging* / Q000209:etiology; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies