Joint problems in patients on maintenance hemodialysis

A questionnaire about joint symptoms was sent to 130 maintenance hemodialysis patients. All patients had a skeletal survey to assess the degree of hyperparathyroidism. 40 patients had no joint symptoms, 31 had mild joint symptoms, and 59 had severe joint symptoms. A higher proportion of these patients had radiological evidence of hyperparathyroidism, vascular or soft tissue calcification. Several different patterns of joint symptoms evolved including calcification problems, carpal tunnel syndrome, avascular necrosis, ruptured tendon and infection. We also describe a new syndrome of recurrent hemarthroses progressing to chronic capsulitis occurring in patients who have been on dialysis for more than 10 years.