Document Detail


Destructive arthropathy of the hands in chronic hemodialysis patients. A report of seven cases with pathological documentation.
MedLine Citation:
PMID:  7606419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Destructive arthropathy of the hands is common in chronic hemodialysis patients. The clinical and histological features in seven cases are reported. There were five females and two males aged 45 to 78 years. Hemodialysis duration at the time of surgery was 48 to 228 months (mean 92 months). Four patients had arthrodesis, two had insertion of silastic implants and one had a diagnostic surgical biopsy. The site of the surgical procedure was a distal interphalangeal joint in three patients, a proximal interphalangeal joint in one, a trapeziometacarpal joint in two, and both a proximal and a distal interphalangeal joints in one. All seven patients had severe destructive arthropathy responsible for pain and instability. Roentgenograms showed joint space obliteration and subchondral erosions or lysis, without osteophytosis. Several finger joints were involved in six of the seven patients. Histologic studies of the synovial membrane (n = 7) and subchondral bone (n = 4) found no amyloid even in the three patients with clinical or roentgenographic evidence of amyloidosis at other sites. Electron microscopy studies were done in two patients and failed to disclose crystals or amyloid. Our findings demonstrate that destructive arthropathy of the hands in hemodialysis patients is not a manifestation of dialysis-related amyloidosis. The pathophysiology of the condition remains poorly understood.
Authors:
R M Flipo; X Le Loët; J L Siame; J Benoit; D Goutallier; B Duquesnoy; T Bardin
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Revue du rhumatisme (English ed.)     Volume:  62     ISSN:  1169-8446     ISO Abbreviation:  Rev Rhum Engl Ed     Publication Date:  1995 Apr 
Date Detail:
Created Date:  1995-08-17     Completed Date:  1995-08-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9313916     Medline TA:  Rev Rhum Engl Ed     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  241-7     Citation Subset:  IM    
Affiliation:
Department of Rheumatology, Hospital B, Lille, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Hand* / radiography,  surgery
Humans
Joint Diseases / etiology*,  physiopathology,  surgery
Male
Middle Aged
Renal Dialysis / adverse effects*

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