Weekly Case

Title : Case 626

Age / Sex : 74 / F


Chief complaint : Left hip pain

What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).

Courtesy : Sheen-Woo Lee, Gachon University Gil Hospital



Discussion


Answer: Dialysis-related amyloidosis


 


Findings: Multiple bone erosions in both femoral head and neck. Low signal mass-like material in both femoral head and hip joint (left>right).


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Differential Diagnosis: Tenosynovial giant cell tumor, gout, AVN


 


Discussion: Deposition of β2-microglobulin in joint of patients undergoing long-term hemodialysis. Conventional radiograph will show cystic radiolucencies with sclerotic rim, without matrix calcifications, commonly in hips, wrists, shoulders, knees, spine. MRI will show mass of low signal intensity, with variable T2 signal as result of combination of amyloid deposits and fluid collection.


 


 


References: Dialysis-Related Amyloidosis Revisited, AJR 2005; 185:1460–1467


 


 



Correct Answer
Total applicants 28 Correct answers 9
Name Institution
장민영 국민건강보험공단 일산병원, 전문의
김기욱 국군대전병원, 전문의
김창현 365병원, 전문의
조은경 새움병원, 전문의
이혜란 전문의
김지은 서울대학교병원, 전문의
이지현 삼성서울병원, 전문의
송윤아 전문의
심주경 순천향대 부천병원, 전공의


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