Ghonge Nitin P, Goyal Nidhi, Jain Tanya, Baweja Pankaji
Department of Radiology, Indraprastha Apollo Hospital, New Delhi, India.
Department of Pathology, Indraprastha Apollo Hospital, New Delhi.
Indian J Radiol Imaging. 2025 Feb 12;35(3):481-484. doi: 10.1055/s-0045-1802583. eCollection 2025 Jul.
Amyloid arthropathy is a rare but serious complication in patients with chronic renal failure with a history of prolonged hemodialysis. The underlying pathophysiology is the accumulation of beta-2 microglobulin in intra- and periarticular tissues, with consequent synovial thickening and erosions. Imaging-based diagnosis of amyloid arthropathy allows prompt clinical management and better patient outcomes. In view of vague clinical presentation and uncommon incidence, the radiologist is often the first one to suspect this complication. We hereby describe the case of a 66-year-old man with gradually progressive left hip pain for the past 6 months who was diagnosed to have bilateral amyloid arthropathy and was subsequently confirmed with computed tomography (CT) guided synovial biopsy. Amyloid arthropathy should be considered in patients with hip pain who are on long-term hemodialysis and present with suggestive findings on radiograph, CT, and magnetic resonance studies.
淀粉样关节病是慢性肾衰竭且有长期血液透析病史患者中一种罕见但严重的并发症。其潜在的病理生理学机制是β2微球蛋白在关节内和关节周围组织中蓄积，继而导致滑膜增厚和侵蚀。基于影像学的淀粉样关节病诊断有助于及时进行临床处理并改善患者预后。鉴于临床表现不明确且发病率低，放射科医生往往是首个怀疑此并发症的人。我们在此描述一例66岁男性患者，其在过去6个月中左髋部疼痛逐渐加重，被诊断为双侧淀粉样关节病，随后经计算机断层扫描（CT）引导下的滑膜活检得以确诊。对于长期接受血液透析且髋部疼痛、X线片、CT及磁共振成像检查有提示性表现的患者，应考虑淀粉样关节病的可能。
