[Ultrasonographic evaluation of shoulder joints in hemodialysis patients]

Dialysis-related amyloidosis (DRA) is a serious complication in patients receiving long-term hemodialysis. Intrigued by the fact that the shoulder joint is primarily favored by DRA, we measured the shoulder-capsular distance (SCD) by ultrasonography to investigate the relationship between SCD and the duration of hemodialysis, patient age and biochemistry findings. The SCD of patients receiving hemodialysis was significantly increased, and there was a positive correlation between SCD and the duration of hemodialysis. The SCD tended to show a significant increase in patients receiving long-term hemodialysis over 10 years. Although the SCD was not significantly correlated with serum levels of beta 2-microglobulin and C-PTH, there was a significant positive correlation between the SCD and the serum levels of AI. In patients receiving long-term hemodialysis for 10 years or more, the SCD was increased significantly in the groups patients with the complications of carpal tunnel syndrome (CTS), cystic radiolucencies (CRL) or destructive spondyl arthropathy (DSA) compared with the value in complication-free patients. The results of this study suggest that the majority of patients with SCD > 8mm had the complication of DRA. Since ultrasonography is a non-invasive, east-to-perform procedure, ultrasonographic measurement of the SCD seems to be useful in the diagnosis of DRA.