抄録
(purpose)Shoulder pain occuring in patients on long-term hemodialysis is very severe during hemodialysis and sleeping at night, and is a characteristic finding not observed in other diseases. We performed arthroscopic debridements on those cases with good results. However, the cases of this pain has not been confirmed. To clarify the mechanism of this pain, we histologically examined tissue specimens obtained during surgery.
(Materials and methods)Specimens of the synovium and cartilage were obtained from the glenohumeral joint(GH-j) and subacromial bursa(SAB) at the time of arthroscopic debridement. These specimens were stained with Congo-red, and the localization of the amyloid was evaluated by polarizing microscopy. Nerve cells were examined by S-100 staining and vascular hyperplasia by a α-smooth muscle actin(α-SMA)staining.
(Results)Amyloid was present in the synovium, on the sinovial surface, and on the cartilage suface. In the synovium, there was no increase in the number of nerve cells. The blood vessels in the synovium had deceased. These findings were similarly observed in the GH-j and SAB.
(Conclusion)No increase was observed in the nerve cells in the synovium, and the number of blood vessels was decreased. However, the disappearance of pain after a synovectomy and debridement suggests that amyloid deposition in the synovium and on the cartilage surface trigger pain.
