Imaging Findings in Amyloid Arthropathy of the Hip Joints: The Eyes Cannot See What the Mind Does Not Know

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.