Age / Sex : 51 / M

Chief complaint : Pain and swelling in both hip joints

                          Underlying multiple myeloma


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 : 정준용(Jung, Joon-Yong), 가톨릭대학교 서울성모병원 (Seoul St. Mary’s Hospital)

Amyloid Arthropathy (Amyloidosis)

Discussion

• Disease definition
  - Amyloidosis is characterized by the extracellular deposition of amyloid protein and protein derivatives. Amyloid arthropathy commonly affects the shoulders, wrists, elbows, hips, and knees and may present with swelling, arthralgia, and carpal tunnel syndrome.

• Findings

1. Large erosions filled with low signal material


2. Low signal capsular thickening


3. Synovitis and mild to moderate enhancement of material within erosions

• Differential diagnosis

1. Pigmented villonodular synovitis


2. Gout

• References

1.Sheldon PJ, Forrester DM. Imaging of amyloid arthropathy. Seminars in musculoskeletal radiology 2003:03;195-204

2.Otake S, Tsuruta Y, Yamana D, Mizutani H, Ohba S. Amyloid arthropathy of the hip joint: MR demonstration of presumed amyloid lesions in 152 patients with long-term hemodialysis. European radiology. 1998;8:1352-6.

3.2. Fautrel B, Fermand JP, Sibilia J, Nochy D, Rousselin B, Ravaud P. Amyloid arthropathy in the course of multiple myeloma. The Journal of rheumatology. 2002:29(7):1473-81.