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(Radiology. 2000;217:539-543.)
© RSNA, 2000

Musculoskeletal Imaging

Shoulder Appearances at MR Imaging in Long-term Dialysis Recipients1

John P. Slavotinek, MBBS, BSc, FRACR, P. Toby H. Coates, MBBS, FRACP, Stephen P. McDonald, MBBS, FRACP, Alex P. S. Disney, MBBS, FRACP and Michael R. Sage, MBBS, MD, FRCR, FRACR, FRCP(Edin), FRCP(Lond)

1 From the Department of Medical Imaging, Flinders Medical Centre, Bedford Park, South Australia 5042, Australia (J.P.S., M.R.S.); the Renal Unit, Queen Elizabeth Hospital, Woodville, South Australia (P.T.H.C., A.P.S.D.); and the Menzies School of Health Research, Royal Darwin Hospital, Casuarina, Northern Territory, Australia (S.P.M.). Received May 28, 1999; revision requested July 19; final revision received February 25, 2000; accepted March 7. Address correspondence to J.P.S. (e-mail: rajps@flinders.edu.au).

PURPOSE: To examine shoulder appearances at magnetic resonance (MR) imaging in long-term dialysis recipients.

MATERIALS AND METHODS: Twenty-two chronic dialysis recipients underwent 1.0-T MR imaging with a combination of T1-, T2-, and T2*-weighted sequences. Rotator cuff tendon thickening was graded as present or absent by a musculoskeletal radiologist, who also measured the supraspinatus and subscapularis tendon thicknesses with electronic calipers. The long-axis dimension and location of focal osseous lesions, in addition to their T1, T2, and T2* signal intensities, were noted.

RESULTS: Supraspinatus (n = 9) and subscapularis (n = 10) tendon thickening was frequently observed. Six (27%) of the 22 patients had combined thickening of the supraspinatus and subscapularis tendons without substantial involvement of the infraspinatus or teres minor tendons. These patients had undergone dialysis longer (median, 19.2 years; range, 16.3–22.8 years) than had the other patients (median, 11.7 years; range, 5.8–19.3 years; P = .004). The 29 intraosseous lesions had high, intermediate, and low T2 signal intensity in six (21%), nine (31%), and 14 (48%) instances, respectively.

CONCLUSION: Supraspinatus and/or subscapularis tendon thickening is common in chronic dialysis recipients. Bone lesions in such patients are of variable T2 signal intensity and usually subchondral or adjacent to the greater tuberosity.

Index terms: Amyloidosis, 41.68 • Dialysis • Shoulder, abnormalities, 41.68 • Shoulder, MR, 41.121411, 41.121412, 41.121416 • Tendons, 41.68 • Tendons, MR, 41.121411, 41.121412, 41.121416




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