Amyloidosis may involve a range of ligaments and tendons.
Presentations may include:
(1) carpal tunnel syndrome
(2) rotator cuff tears
(3) lumbar spinal stenosis
(4) trigger finger
(5) spontaneous rupture of the distal biceps tendon
(6) spontaneous rupture of the quadriceps tendon
(7) myopathy with pseudo-hypertrophy
(8) arthropathy
(9) hematoma within a ligament
If a patient has one of these findings as well as heart or kidney disease, then amyloidosis should be considered.
Tissue specimens can be screened with Congo Red stain.
Immunohistochemical staining for:
(1) transthyretin
(2) immunoglobulin light chain
(3) amyloid A protein
(4) beta-2-microglobulin
