Arthropathy in haemodialysed patients

The joint disorders associated with osteodystrophy of 124 regularly haemodialysed patients are reviewed. The most common signs and symptoms of uraemic osteoarthropathy are summed up. It is pointed out that in osteoarthropathy accompanying chronic renal failure or haemodialysis the bones are generally affected first, arthropathy being secondary to this process. In addition to the classic signs and symptoms of arthropathy (calcification, pain, stiffness) capsulitis, carpal tunnel syndrome and in 3 cases avascular necrosis were observed. The laboratory findings included hypocalcaemia, hyperphosphataemia and hypersecretion of parathormone. The current preventive and therapeutic measures are reviewed and in this context the benefits of combined local lidocaine, and steroid iontophoresis are emphasized in the light of personal observations.