Hemodialysis Induced Amyloid Arthropathy of Hip Presenting as Pathological Fracture-A Case Report and Literature Review

摘要

Amyloid arthropathy is a recognized complication of chronic renal failure with long term dialysis. The amyloid, a beta 2microglobulin is not filtered by dialysis membrane and remains in the circulation, gets deposited over the synovium, articular bones and cartilage. As a result the large joints like shoulder, hips and knees show cystic bone lesions. The radiological features precede the clinical symptoms. The majority of the patients remain asymptomatic till the advanced stage or may present with pathological fracture. The patient in this case report had a long history of dialysis due to renal failure and presented with pain, limping and difficult to walk after the history of fall in bathroom. The radiological investigations, particularly MRI hip had typical signs of amyloid arthropathy; later on confirmed by biopsy. This case report is presented to call attention of clinicians and radiologists for the early and prompt diagnosis of amyloid arthropathy, avoiding false/delayed diagnosis which can increase morbidity and mortality.