title: Ultrasonographic tendon alteration in relation to parathyroid dysfunction in chronic hemodialysis patients.
abstract: OBJECTIVE
  To find the nature of tendon involvement in chronic kidney disease (CKD) patients on regular hemodialysis (RD), and its relationship to parathyroid hormone (PTH) level using ultrasonography (US).
  
  
  METHODS
  A total of 50 CKD patients on RD subjected to musculoskeletal examination of knee and ankle, laboratory evaluation, and US of quadriceps tendon and Achilles tendon were involved.
  
  
  RESULTS
  Ankle joint tenderness was the most frequent sign on examination. US of the Achilles tendons showed tenderness during probing in 44% patients, calcific deposition in 24% patients, abnormal peritendon tissue in 20% patients, and abnormal anteroposterior (A-P) middle and distal one-third thicknesses of the Achilles tendon in 20% and 18% patients, respectively. PTH positively correlated with the duration of dialysis, serum phosphorus level, presence of calcific deposit, and increased thickness of the Achilles tendon.
  
  
  CONCLUSIONS
  The most common ultrasonographic finding in CKD patients on RD was Achilles tendon tenderness during probing. PTH level positively correlated with the duration of dialysis, presence of calcific deposit, and increased thickness of Achilles tendon.
authors: Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
authors: Dahlia A
authors: DA
authors: Hussein
authors: Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
authors: Noran O
authors: NO
authors: El-Azizi
authors: Department of Internal Medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
authors: Ali H
authors: AH
authors: Abdel Meged
authors: Department of Radiology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
authors: Sameh A
authors: SA
authors: Al-Hoseiny
authors: Department of Clinical and Chemical Pathology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
authors: Abdelhady M
authors: AM
authors: Hamada
authors: Department of Clinical and Chemical Pathology, Faculty of Medicine, Ain Shams University, Abbassia, Cairo, Egypt.
authors: Moshira H
authors: MH
authors: Sabry
keywords: Achilles tendon; Chronic kidney disease (CKD); anteroposterior (A-P); chronic kidney disease (CKD); musculoskeletal ultrasound; parathyroid hormone (PTH); renal osteodystrophy (ROD); tuberculosis (TB)