Haemodialysis induced amyloid arthropathy of hip

Case contributed by Salman S. Albakheet
Diagnosis certain

Presentation

Chronic renal failure and long term haemodialysis for 13 years, presented with progressive bilateral hip pain.

Patient Data

Age: 70 years
Gender: Male

Bilateral femoral head and neck subchondral cystic lesions with well-defined sclerotic margins. No obvious fracture.

Diffuse vascular calcification.

There are multiple well defined subcortical mass lesions at femoral head and neck bilaterally. It shows low signal on T1, heterogeneous predominantly low signal on T2 with cystic changes and peripheral enhancement on post contrast.  Mild bilateral anterior capsular enhancement and swelling.

Soft tissue lesion of similar signal intensity and enhancement seen posterior to right ischial tuberosity. No significant joint effusion.  

Case Discussion

Tissue biopsy was taken by CT guidance and histolopathology report was: red stain positive fibrous material indicating beta 2microglobulin amyloid arthropathy.

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