Abstract
(Purpose) Shoulder pain is a common complaint of hemodialyzed (HD) patients. But the pathogenesis of such an arthropathy is still poorly understood. We investigated plain X-P, MRI, and the pathological findings in shoulders of HD patients and discussed about the pathogenesis of the their shoulder pain. (Materials and methods) Sixteen patients (29 shoulders) with shoulder pain, who had undergone HD for an average of 14 years, were studied. Their average age was 63 years old. Plain X-P and MRI findings of their shoulders were evaluated and synovial tissue of the subacromial bursa (SAB), which was obtained from a synovectomy of the SAB, was also evaluated.
(Results) With the findings of plain X-P, there was only 1 case of definite joint destruction. From the MRI findings, in over half of all the cases, there was glenohumeral synovitis or subacromial bursitis. The rotator cuffs showed a deposition of amyloid and its mean thickness was 5.9 mm. Six patients (7shoulders) underwwent a synovectomy of SAB. In all the cases, we identified a deposition of amyloid in the synovial tissue.
(Conclusions) From the MRI findings and pathological findings of synovial tissue, the pathogenesis of shoulder pain in HD patients are amyloid induced synovitis and. rotator cuff tendinitis.
