Bone Lesions of the Hand and Wrist in Patients Undergoing Hemodialysis for Ten Years

We investigated the chronological changes in the plain radiographs of the hands and wrists of 32 patients who underwent hemodialysis for ten years. Digital image processing (DIP)(9) and quantitative computed tomography (QCT) were conducted to examine bone density. Fourteen patients underwent Magnetic Resonance Imaging (MRI) of the wrists, and the relationships between MRI findings and plain radiographic findings and association of carpal tunnel syndrome (CTS) were investigated. Twenty-one patients with bone lesions revealed by plain radiography were classified into four groups - cystic lesion, bone resorption, mixed, and no-lesion groups. Subperiosteal bone resorption was seen in 17 patients at ten years, of whom one showed a marked improvement of bone lesion observed at five years. Twelve patients had cystic lesions at ten years, most often observed in the middle phalanx and lunate. Seven of those 12 patients suffered from CTS, in contrast to only one case with CTS in each of the bone resorption and no-lesion groups. DIP and QCT revealed the most severe bone atrophy in the cystic lesion group. In six patients, MRI revealed bone lesions not detected by plain radiographs.