“ Results from deposition of amyloid protein in the joints. Mostly it occurs secondary to end-stage renal failure and amyloid protein not be...
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Results from deposition of amyloid protein in the joints. Mostly it occurs secondary to end-stage renal failure and amyloid protein not being filtered by standard dialysis membranes (a primary type also exists). Classically stains with Congo red. Common clinical features are shoulder pain and carpal tunnel syndrome.
Three patterns are described:
- amyloid arthropathy,
- diffuse marrow deposition
- focal destructive lesion (‘amyloidoma’—rare).
PLAIN FILM
• Multiple small lucencies in the medulla or bone cortex—may cause cortical destruction.
• Usually found in periarticular bone, often bilateral.
• Look for subtle cortical irregularity or foveal enlargement.
ULTRASOUND (US)
• Thickening of supraspinatus (>7 mm) or the biceps tendon (>4 mm) or cuff tears
• Joint/bursa effusion
• Bone lesions are low signal on T1 (variable T2 signal) and enhance following gadolinium.
• Thickened synovium of low signal on T2.
• Intrarticular nodules, which are low signal on T1 and T2, communicate with the subchondral bone lesions.
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