Sonographic evaluation of entheseal sites of the lower extremity in patients undergoing hemodialysis.
OBJECTIVE
To evaluate the entheseal sites of the lower extremities in patients on hemodialysis using the Glasgow Ultrasound Enthesitis Scoring System (GUESS) and to correlate the findings with the duration of hemodialysis and patient scores.


METHODS
Forty-nine patients who were on hemodialysis for at least 2 years were grouped according to duration of hemodialysis. Total GUESS scores; total enthesophyte, erosion, and bursitis scores; and tendon thicknesses were calculated, compared between groups, and correlated with duration of dialysis.


RESULTS
There was a statistically significant correlation between duration of hemodialysis and total GUESS score (p < 0.001, r = 0.81) and also between the total enthesophyte and erosion scores (p < 0.001). If severe enthesitis was defined as a total GUESS score of more than 18, receiver operating characteristic (ROC) curve analysis revealed that a cutoff point of 10 years for the duration of hemodialysis would predict severe enthesal damage with 83% sensitivity and 93% specificity (area under the ROC curve, 0.92; 95% confidence interval, 0.83-1.00).


CONCLUSIONS
Hemodialysis results in entheseal site changes that worsen with extended duration of hemodialysis, especially after 10 years.
Department of Radiology, Hacettepe University, School of Medicine, Sihhiye 06100, Ankara, Turkey.
Ulku
U
Kerimoglu
Mutlu
M
Hayran
Fatma Bilge
FB
Ergen
Alper
A
Kirkpantur
Cetin
C
Turgan
D000293:Adolescent; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000378:metabolism; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*; D012720:Severity of Illness Index; D014463:Ultrasonography; D001613:beta 2-Microglobulin / Q000378:metabolism
D010281:Parathyroid Hormone; D001613:beta 2-Microglobulin