A patient undergoing chronic hemodialysis may accumulate beta2-microglobulin. This protein may form amyloid deposits, particularly in and about bones and joints.
Spectrum of joint disorders seen with dialysis-related amyloidosis:
(1) chronic arthralgias involving shoulders, knees, wrist and small hand joints
(2) periarticular soft tissue swelling
(3) recurrent hemarthroses
(4) chronic tenosynovitis
(5) destructive arthropathy of large peripheral joints
(6) destructive spondylarthropathy involving the spine
Other orthopedic disorders
(1) carpal tunnel syndrome
(2) bone cysts which can result in pathologic fractures
(3) subchondral bone erosions
CT can often demonstrate changes to the bone while MRI may identify amyloid deposits in soft tissue.
The beta2-microglobulin can be demonstrated in biopsies if sufficient amounts are present.
The patient may develop impaired joint mobility and chronic pain, which can result in significant disability.
Purpose: To identify amyloid arthropathy and other types of orthopedic involvement in dialysis-associated amyloidosis.
Specialty: Immunology/Rheumatology, Surgery, orthopedic, Infectious Diseases
Objective: risk factors, response to therapy, quality of life
ICD-10: Z49, E85,