Magnetic resonance imaging in patients with hemodialysis-related arthropathy

From April 1993 to December 1993, we prospectively studied the knees of 15 patients (mean age, 48 +/- 11 yr) receiving long-term hemodialysis (mean duration, 9 +/- 4 yr) using magnetic resonance imaging (MRI) techniques including, T1 weighted spin-echo, multiplanar gradient recalled, and postcontrast T1 with chemical shift-selective, fat-saturation pulse sequences. Analysis of these images revealed that the three findings most indicative of hemodialysis-related arthropathy were intramedullary, cortical and soft tissue lesions. Knee pain was significantly correlated with the presence of soft tissue lesions. Cortical lesions were usually associated with soft tissue lesions. Inflammatory changes adjacent to soft tissue lesions were demonstrated in postcontrast studies in all patients with soft tissue lesions. Increases in water content in those lesions appeared to increase the signal intensity. Our results indicate that MRI is useful in demonstrating the extent of hemodialysis-related arthropathy involvement, especially in hemodialysis patients suffering from knee pain.