title: Magnetic resonance imaging classification of haemodialysis-related amyloidosis of the shoulder: risk factors and arthroscopic treatment.
abstract: OBJECTIVE
  This study proposed new magnetic resonance imaging (MRI) of haemodialysis shoulders (HDS) focusing on the changes of the rotator cuff, and rotator interval and risk factors for the development of HDS were examined.
  
  
  METHODS
  Eighty-five shoulders in 72 patients with a chief complaint of shoulder pain during haemodialysis and at least 10 years of haemodialysis were included. They were classified into 5 groups based on the thickness of the rotator cuff and conditions of rotator interval. Clinical and radiological findings in each grade were examined, and risk factors for the development of HDS were evaluated. Arthroscopic surgeries were performed on 22 shoulders in 20 patients, and arthroscopic findings were also evaluated.
  
  
  RESULTS
  Positive correlations for the development of HDS were observed in duration of haemodialysis, positive hepatitis C virus (HCV) infection, and previous haemodialysis-related orthopaedic surgery (P < 0.001, respectively). Strong correlations were observed between positive HCV and the progression of HDS (odds ratio 24.8, 95 % confidence interval 5.7-107.6). Arthroscopically, progression of the surrounding soft tissue degeneration was observed, and operative times were lengthened depending on the progression of MRI grading.
  
  
  CONCLUSIONS
  A new MRI classification of HDS which may be helpful when considering arthroscopic surgeries has been proposed. Positive HCV infection was strongly associated with the progression of HDS on MRI. Conditions of the rotator interval and the rotator cuff based on the MRI classification should be examined when treating HDS patients.
  
  
  METHODS
  III.
authors: Department of Orthopaedic Surgery, JCHO Sendai Hospital, 3-16-1 Tsutsumimachi, Aobaku, Sendai, Japan.
authors: Akira
authors: A
authors: Ando
authors: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan. hagi@med.tohoku.ac.jp.
authors: Yoshihiro
authors: Y
authors: Hagiwara
authors: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan.
authors: Takuya
authors: T
authors: Sekiguchi
authors: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan.
authors: Masashi
authors: M
authors: Koide
authors: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan.
authors: Kenji
authors: K
authors: Kanazawa
authors: Division of Epidemiology, Department of Public Health and Forensic Medicine, Tohoku University School of Medicine, 2-1 Seiryomachi, Aobaku, Sendai, Japan.
authors: Takashi
authors: T
authors: Watanabe
authors: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aobaku, Sendai, Japan.
authors: Eiji
authors: E
authors: Itoi
mesh_terms: D000686:Amyloidosis / Q000145:classification* / Q000000981:diagnostic imaging* / Q000209:etiology; D001182:Arthroscopy; D005260:Female; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011859:Radiography; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000601:surgery; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D020069:Shoulder Pain / Q000209:etiology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
keywords: Arthroscopic surgery; Classification; Haemodialysis shoulder; Hepatitis C virus; Magnetic resonance imaging; Risk factor