Clinical studies of destructive spondylarthropathy in long-term hemodialysis patients

Maruyama, Haruhiko; Homma, Noriyuki; Gejyo, Fumitake; Kobayashi, Naoyuki; Imai, H.; Ueki, K; Ei, K; Oda, Mizue; Arakawa, Masaaki

doi:10.4009/jsdt1985.22.741

Cited by 3 publications

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“…This study indicated DSA to be localized in lower cervi cal spine areas, which is consistent with findings of earlier studies [1][2][3][4]6,7,10,[12][13][14][15][16][17], In most patients of those studies, detection of DSA was based on local pain [1-3, 6, 7], however, which was not seen in most cases of this study. For these patients, radiographs of the spine provided clues for the diagnosis of asymptomatic DSA.…”

Section: Discussionsupporting

confidence: 77%

“…Hardouin et al [4] found DSA in 7 of 80 patients (8.8%) and Kessler et al [II] in 2 of 40 patients (5.0%) on dialysis for more than 10 years. Maruyama et al [12] reported 8 such patients out of 181 dialyzed patients (4.4%) and Iwamoto et al [13] 22 of 87 patients (25.3%) on dialysis for more than 10 years. The present study disclosed 37 of 405 patients (9.1%), and 21 of 157 patients (13.4%) dialyzed for more than 10 years.…”

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confidence: 99%

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Clinical Studies of Destructive Spondyloarthropathy in Long-Term Hemodialysis Patients

Maruyama¹,

Gejyo²,

Arakawa³

1992

Nephron

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Destructive spondyloarthropathy (DSA) has recently been recognized in hemodialysis patients. This study was undertaken to assess the prevalence, preferred sites, risk factors, early radiological manifestations, magnetic resonance imaging (MRI) and relation to other radiological features and biochemical variables in DSA. In 405 patients undergoing dialysis for 0.2-20.5 years (average 8.2) with a mean age of 51.9 years (range 24-84), a diagnosis of DSA was made for 37 (9.1%). The preferred site of DSA was the lower cervical spine. MRI indicated a low signal intensity of the involved vertebral regions on both T₁ and T₂-weighted images and thus appeared useful in the exclusion of osteomyelitis showing high-intensity T₂-weighted images. The patients were divided into three groups according to radiological findings: those showing (A) the presence of DSA, (B) vertebral rim erosion (VRE) without DSA, and (C) the absence of DSA and VRE. Patient age at onset of dialysis (p < 0.01) and duration of hemodialysis (p < 0.05) appeared to be the associated risk factors for DSA. DSA was found correlated with carpal tunnel syndrome (p < 0.01), carpal bone cystic radiolucency (p < 0.01), and amyloid deposit (p < 0.01). All the groups were essentially the same with respect to the incidence of ectopic calcification, secondary hyperparathyroidism, biochemical markers and sex distribution. The results of this study show DSA to be associated with dialysis amyloidosis.

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Section: Discussionsupporting

confidence: 77%

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confidence: 99%

Clinical Studies of Destructive Spondyloarthropathy in Long-Term Hemodialysis Patients

Maruyama¹,

Gejyo²,

Arakawa³

1992

Nephron

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“…Alcalay et al [3] and McCarthy et al [4] maintain hyperpar athyroidism to be essential in the development o f D SA . The theory of dialysis amyloidosis [5] is supported by Sebert et al (6], Bardin et al [7], and Maruyama et al [8]. In this study, in 11 out o f 20 patients had carpal tunnel release, and [T-microglobulin-associated amyloid depos its were noted in finger flexor synovium, thus showing D SA to be quite likely associated with dialysis amyloid osis.…”

Section: Discussionsupporting

confidence: 70%

A Magnetic Resonance Imaging Study of Destructive Spondyloarthropathy in Long-Term Hemodialysis Patients

Maruyama

Gejyo²,

Arakawa³

1991

Nephron

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It is most important to differentiate destructive spondyloarthropathy (DSA) from vertebral osteomyelitis (VOM), both showing similar roentgenographic findings and evaluate the spinal involvement of DSA. Magnetic resonance imaging (MRI) is useful for morphological and biochemical analysis of spinal lesions, but few studies have been conducted on DSA. The authors detected 20 patients with DSA among 237 hemodialysis patients and conducted a study on 4 of them. The involved vertebral regions all showed low signal intensity on T1- and T2-weighted images. VOM can be visualized as areas of high signal intensity on T2-weighted images. In 2 of the patients, impingement was noted on the thecal sac both anteriorly and posteriorly. From the results of this study, MRI of DSA was shown to facilitate the exclusion of infectious processes and evaluation of spinal involvement.

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Grading of cervical spine abnormalities by plain X-ray examination in long-term hemodialysis patients.

Kanai

Hirakata

et al. 1995

Nihon Toseki Igakkai Zasshi

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Clinical studies of destructive spondylarthropathy in long-term hemodialysis patients

Cited by 3 publications

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Clinical Studies of Destructive Spondyloarthropathy in Long-Term Hemodialysis Patients

Clinical Studies of Destructive Spondyloarthropathy in Long-Term Hemodialysis Patients

A Magnetic Resonance Imaging Study of Destructive Spondyloarthropathy in Long-Term Hemodialysis Patients

Grading of cervical spine abnormalities by plain X-ray examination in long-term hemodialysis patients.

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