Dialysis-related spondyloarthropathy

Dialysis-related spondyloarthropathy is a relatively uncommon complication of renal dialysis. It is part of the spectrum of dialysis-related amyloidosis. 

Pathology

Thought to be mainly due to extensive deposition of beta-2 microglobulin (amyloid-like substance) within the spine (especially intervertebral discs). The disease often correlates with the duration of haemodialysis.

Radiographic features

Plain radiography / CT 

Non-specific but may result in sclerosis, erosion, and cyst formation along adjacent end plates in single or multiple levels. There may also be vertebral body collapse and disc space narrowing.

MRI

Amyloid deposits are typically low signal on T1 and T2 weighted images, which is most helpful in pointing to this entity. The T2 signal in the disc space can occasionally be high but is not usually as high as in infectious spondylodiscitis.

Differential diagnosis

Consider:

• infective discitis/spinal osteomyelitis/infectious spondylitis

See also

• amyloid arthropathy
• amyloidosis