Adhesive Capsulitis of the Shoulder

Adhesive capsulitis, the so-called ‘frozen shoulder’, is one of the common causes of pain with a limited range of motion in the shoulder joint. The condition is usually diagnosed through the clinical course and physical examinations; however, several studies on imaging findings of adhesive capsulitis using sonography, MRI, and MR angiography have been reported. In this article, various imaging findings for the diagnosis of adhesive capsulitis-related anatomy are reviewed.

Thyroid Nodules with Isolated Macrocalcifications:Malignancy Risk of Isolated Macrocalcifications andPostoperative Risk Stratification of Malignant TumorsManifesting as Isolated Macrocalcifications

Objective@#To determine the malignancy risk of isolated macrocalcifications (a calcified nodule with complete posterioracoustic shadowing) detected on ultrasonography (US) and to evaluate the postoperative American Thyroid Association (ATA)risk stratification of malignant tumors manifesting as isolated macrocalcifications. @*Materials and Methods@#A total of 3852 thyroid nodules (≥ 1 cm) of 3061 consecutive patients who had undergone biopsybetween January 2011 and June 2018 were included in this study. We assessed the prevalence, malignancy rate, and sizedistribution of isolated macrocalcifications and evaluated the histopathologic features and postoperative ATA risk stratificationof malignant tumors manifesting as isolated macrocalcifications. @*Results@#Isolated macrocalcifications were found in 38 (1.2%) of the 3061 patients. Final diagnosis was established in 30(78.9%) nodules; seven malignant tumors were diagnosed as papillary thyroid carcinomas (PTCs). The malignancy rate of theisolated macrocalcifications was 23.3% in the 30 nodules with final diagnoses and 18.4% in all nodules. Among the sixsurgically-treated malignant tumors, five (83.3%) had an extrathyroidal extension (ETE) (minor ETE 1, gross ETE 4), and two(33.3%) had macroscopic lymph node metastasis. Four (66.7%) malignant tumors were categorized as high-risk tumors, one asan intermediate-risk tumor, and one as a low-risk tumor using the ATA risk stratification. Histopathologically, out of the sixmalignant tumors, ossifications were noted in four (66.7%) and predominant calcifications in two (33.3%). @*Conclusion@#The US pattern of isolated macrocalcifications (≥ 1 cm) showed an intermediate malignancy risk (at least 18.4%).All malignant tumors were PTCs, and most showed an aggressive behavior and a high or intermediate postoperative ATA risk.

Analysis of the Risk Factors for Unfavorable Radiologic Outcomes after Fusion Surgery in Thoracolumbar Burst Fracture : What Amount of Postoperative Thoracolumbar Kyphosis Correction is Reasonable?

OBJECTIVE: The aims in the management of thoracolumbar spinal fractures are not only to restore vertebral column stability, but also to obtain acceptable alignment of the thoracolumbar junction (T-L junction) to prevent complications. However, insufficient surgical correction of the thoracolumbar spine would be likely to cause late progression of abnormal kyphosis. Therefore, we identified the surgical factors that affected unfavorable radiologic outcomes of the thoracolumbar spine after surgery. METHODS: This study was conducted in a single institution from January 2007 to December 2013. A total of 98 patients with unstable thoracolumbar spine fracture were included. In these patients, fixation was done through transpedicular screws with rods by three surgical patterns. We reviewed digital radiographs and analyzed the images preoperatively and postoperatively during follow-up visits to compare the change of the thoracolumbar Cobb angle with radiologic parameters and clinical outcomes. The unfavorable radiologic group was defined as the patients who were measured as having greater than 20 degrees of thoracolumbar Cobb angle on the last follow-up, or who underwent kyphotic progression of thoracolumbar Cobb angle greater than 10 degrees from the immediate postoperative state to final follow-up, or who had overt instrument failure with/without additional surgery. We assessed the risk factors that affected the unfavorable radiologic outcomes. RESULTS: We had 43 patients with unfavorable radiologic outcomes, including 35 abnormal thoracolumbar alignments and 14 instrumental failures with/without additional surgery. The multivariate logistic regression test showed that immediate postoperative T-L junction Cobb angle less than 10.5 degrees was a statistically significant risk factor, as well as the presence of osteoporosis (p=0.017 and 0.049, respectively). CONCLUSION: Insufficient correction of thoracolumbar kyphosis was considered to be a major factor of an unfavorable radiological outcome. The spinal surgeon should consider that having a T-L junction Cobb angle larger than 10.5 degrees immediately after surgery could result in an unfavorable radiological outcome, which is related to a poor clinical outcome.

Analysis of the Risk Factors for Unfavorable Radiologic Outcomes after Fusion Surgery in Thoracolumbar Burst Fracture : What Amount of Postoperative Thoracolumbar Kyphosis Correction is Reasonable?

OBJECTIVE: The aims in the management of thoracolumbar spinal fractures are not only to restore vertebral column stability, but also to obtain acceptable alignment of the thoracolumbar junction (T-L junction) to prevent complications. However, insufficient surgical correction of the thoracolumbar spine would be likely to cause late progression of abnormal kyphosis. Therefore, we identified the surgical factors that affected unfavorable radiologic outcomes of the thoracolumbar spine after surgery.METHODS: This study was conducted in a single institution from January 2007 to December 2013. A total of 98 patients with unstable thoracolumbar spine fracture were included. In these patients, fixation was done through transpedicular screws with rods by three surgical patterns. We reviewed digital radiographs and analyzed the images preoperatively and postoperatively during follow-up visits to compare the change of the thoracolumbar Cobb angle with radiologic parameters and clinical outcomes. The unfavorable radiologic group was defined as the patients who were measured as having greater than 20 degrees of thoracolumbar Cobb angle on the last follow-up, or who underwent kyphotic progression of thoracolumbar Cobb angle greater than 10 degrees from the immediate postoperative state to final follow-up, or who had overt instrument failure with/without additional surgery. We assessed the risk factors that affected the unfavorable radiologic outcomes.RESULTS: We had 43 patients with unfavorable radiologic outcomes, including 35 abnormal thoracolumbar alignments and 14 instrumental failures with/without additional surgery. The multivariate logistic regression test showed that immediate postoperative T-L junction Cobb angle less than 10.5 degrees was a statistically significant risk factor, as well as the presence of osteoporosis (p=0.017 and 0.049, respectively).CONCLUSION: Insufficient correction of thoracolumbar kyphosis was considered to be a major factor of an unfavorable radiological outcome. The spinal surgeon should consider that having a T-L junction Cobb angle larger than 10.5 degrees immediately after surgery could result in an unfavorable radiological outcome, which is related to a poor clinical outcome.

Synchronous multicentric small hepatocellular carcinomas: defining the capsule on high-frequency intraoperative ultrasonography with pathologic correlation

PURPOSE: The aim of this study was to define the capsules of synchronous multicentric small hepatocellular carcinomas (HCCs) with use of high-frequency intraoperative ultrasonography (IOUS). METHODS: Among the 131 consecutive patients undergoing hepatic resection and high-frequency IOUS for HCC, 16 synchronous multicentric small HCCs in 13 patients were histologically diagnosed in the resected specimens. High-frequency IOUS and pathologic findings of these lesions were compared, with particular focus on the presence and appearance of the capsule in or around each lesion. RESULTS: Synchronous multicentric small HCCs were pathologically classified into distinctly nodular (n=12) or vaguely nodular (n=4) types. All 12 distinctly nodular HCCs including six subcentimeter lesions showed detectable capsules on high-frequency IOUS and pathology. The capsules appeared as a hypoechoic rim containing hyperechoic foci (n=6), hypoechoic rim (n=5), or hyperechoic rim (n=1) with varying degrees of coverage around each lesion. Histologically, the capsules were composed of a combination of one to four layers consisting of a fibrous capsule, peritumoral fibrosis, prominent small vessels, and entrapped hepatic parenchyma. CONCLUSION: Synchronous multicentric small HCCs with distinctly nodular type, even at subcentimeter size, can show capsules with varying coverage and diverse echogenicity on high-frequency IOUS.

CT Findings of Foreign Body Reaction to a Retained Endoloop Ligature Plastic Tube Mimicking Acute Appendicitis: A Case Report

Many hospitals experience one or more retained surgical instrument events with risk of patient morbidity and medicolegal problems. Identification of retained surgical instrument is important. The radiologists should be familiar with imaging finding of retained surgical instrument. In a 62-year-old female with a retained plastic tube, localized peritoneal infiltration around air-containing tubular structure mimicked acute appendicitis on abdomen computed tomography (CT), one year after laparoscopic cholecystectomy. We reported CT findings of foreign body reaction related to retained Endoloop ligature plastic tube mimicking acute appendicitis.

A Provincial Population-Based Survey on Attitudes towards Wills of Individuals with Dementia and Related Issues / 신경정신의학

OBJECTIVES: This study investigated the attitudes of a provincial population towards wills of individuals with dementia and related concerns to prevent civil disputes related to dementia in an aging society. METHODS: The target population was registered residents in a province aged 19 years or older. The population forming the sampling frame was 1478821 (as of May 31, 2013). With a confidence interval of 2% and significance level of 5%, 2540 participants were sampled. This survey used a structured questionnaire composed of two main parts : seven items of general information (sex, age, residence, marital status, education, occupation, and income) and Testamentary Capacity-Related Questionnaire-12 items (TCRQ-12) comprising four items of basic knowledge and eight items of specific situational questions, using a five point Likert scale. RESULTS: The respondents were favorable toward the guarantee of will-making capacity of individuals with dementia. Self-relatedness, disadvantageousness and undue influence are significantly associated with objection to the will of individuals with dementia. In the pre-evaluation of testamentary capacity of individuals with dementia, the respondents responded strongly and with more favorable attitudes for evaluation by medical specialists than by lawyers. Last, in acceptance of the denial of self-related will due to dementia, negative response was dominant over positive response. CONCLUSION: Although it would be desirable that the will or testamentary capacity of individuals with dementia should be guaranteed for maximum, institutional and professional approaches are necessary to prevent civil disputes related to dementia.

Ultrasonography for nerve compression syndromes of the upper extremity

Nerve compression syndromes commonly involve the nerves in the upper extremity. High-resolution ultrasonography (US) can satisfactorily assess these nerves and may detect the morphological changes of the nerves. US can also reveal the causes of nerve compression when structural abnormalities or space-occupying lesions are present. The most common US finding of compression neuropathy is nerve swelling proximal to the compression site. This article reviews the normal anatomic location and US appearances of the median, ulnar, and radial nerves. Common nerve compression syndromes in the upper extremity and their US findings are also reviewed.

Isolation And Development Of Quantification Method For Cyanidin-3-glucoside And Cyanidin-3-rutinoside In Mulberry Fruit By High-performance Countercurrent Chromatography And High-performance Liquid Chromatography

Cyanidin-3-glucoside (C3G) and cyanidin-3-rutinoside (C3R) were isolated by high-performance countercurrent chromatography (HPCCC) using a two-phase solvent system composed of tert-butyl methyl ether/n-butanol/acetonitrile/water/trifluoroacetic acid (1 : 3 : 1 : 5 : 0.01, v/v) to give pure C3G (34.1 mg) and C3R (14.3 mg) from 1.5 g crude mulberry fruit extract. Using the pure C3G and C3R, a reliable high-performance liquid chromatography (HPLC) method was developed and validated to determine the C3G and C3R contents in mulberry fruit. C3G and C3R were separated simultaneously using an Eclipse XDB-C18 column (4.6 x 250 mm I.D., 5 microm) coupled with a photodiode array detector (PDA). The gradient elution of the mobile phase consisting of acetonitrile (0.5% formic acid) and water (0.5% formic acid) was applied (1.0 mL/min), and the detection wavelength was 520 nm. The calibration curves of C3G and C3R showed good linearity (both with r2 = 0.9996) in the concentration range 15.625 - 500 microg/mL, and the relative standard deviations (RSD%) of intra- and interday variability were in the ranges 2.1 - 8.2% and 4.1 - 17.1%, respectively. The accuracies were ranged 96.5 - 102.6% for C3G and C3R, respectively. The developed HPLC method was used to determine the contents of C3G and C3R in newly harvested mulberry from eight different provinces of Korea.

Rapid Isolation of Cyanidin 3-Glucoside and Peonidin 3-Glucoside from Black Rice (Oryza sativa) Using High-Performance Countercurrent Chromatography and Reversed-Phase Column Chromatography

Anthocyanins are water soluble plant pigments which are responsible for the blue, red, pink, violet colors in several plant organs such as flowers, fruits, leaves and roots. In recent years, anthocyanin-rich foods have been favored as dietary supplements and health care products due to diverse biological activities of anthocyanins including antioxidant, anti-allergic, anti-diabetic, anti-microbial, anti-cancer and preventing cardiovascular disease. High-performance countercurrent chromatography (HPCCC) coupled with reversed-phase medium pressure liquid chromatography (RP MPLC) method was applied for the rapid and efficient isolation of cyanidin 3-glucoside (C3G) and peonidin 3-glucoside (P3G) from black rice (Oryza sativa L., Poaceae). The crude black rice extract (500 mg) was subjected to HPCCC using two-phase solvent system composed of tert-butyl methyl ether/n-butanol/acetonitrile/0.01% trifluoroacetic acid (TBME/B/A/0.01% TFA, 1 : 3 : 1 : 5, v/v, flow rate - 4.5 mL/min, reversed phase mode) to give enriched anthocyanin extract (37.4 mg), and enriched anthocyanin extract was sequentially chromatographed on RP-MPLC to yield C3G (16.5 mg) and P3G (8.7 mg). The recovery rate and purity of isolated C3G were 76.0% and 98.2%, respectively, and those of P3G were 58.3% and 96.3%, respectively. The present study indicates that HPCCC coupled with RP-MPLC method is more rapid and efficient than multi-step conventional column chromatography for the separation of anthocyanins.

An Incidental Finding of a Radiopaque Pill following Cervical Spinal Surgery in a Parkinson's Disease Patient

There are previous reports of the identification of radiopaque medications on abdominal X-rays or computed tomography (CT). We describe an interesting case of the incidental identification of a radiopaque medication on cervical spinal CT following cervical spinal surgery. A sixty seven-year-old male patient with Parkinson's disease (PD) visited our emergency center with a C5-6 dislocation and fracture. Surgery was performed with open reduction and pedicle screw fixation through the posterior approach. No abnormal events occurred during the perioperative period. However, a radiopaque incidental foreign body in front of the C6 vertebrae was found on a cervical spinal CT and X-rays that were performed as routine examinations on postoperative day 3. After 6 hours, we performed gastrofibroscopy (GFS) but were unable to find anything. Therefore, we checked all of his medications related to the neck and check X-ray again. One enteric-coated pill he had taken exhibited strong radiodensity. Although our patient underwent an unnecessary GFS, every spinal surgeon should keep in mind that radiopaque pills can appear similar to spinal instruments on X-ray and CT. In addition, we should also know the associated dysphagia is a possible cause of the delayed passage of medicine in PD with or without cervical osteophytes.

Osteochondrolipoma Presenting as a Popliteal Cyst

Here, we describe a popliteal mass that was initially misdiagnosed as a simple popliteal cyst, which finally turned out to be osteochondrolipoma. A 63-year-old housewife presented with sustained knee pain in association with a palpable mass on the popliteal fossa. The mass was in the posteromedial area and soft, non-tender, non-movable in the posteromedial area. Using plain radiography, the mass appeared as a round, soft tissue density lesion containing bony fragments. We performed an ultrasound-guided needle biopsy in conjunction with magnetic resonance imaging, followed by an open excisional biopsy. Microscopically, histological sections showed a lipoma with cartilaginous and osseous differentiation, finally diagnosed as osteochondrolipoma. In conclusion, popliteal masses are not always simple cysts, and the evaluation of masses in the popliteal fossa is always necessary.

Ectopic Insertion of the Pectoralis Minor Tendon: Inter-Reader Agreement and Findings in the Rotator Interval on MRI

OBJECTIVE: To evaluate magnetic resonance imaging (MRI) observer variability to detect ectopic insertion of the pectoralis minor tendon (EIPMT) and to investigate changes in the rotator interval in patients with EIPMT using MRI. MATERIALS AND METHODS: A total of 507 shoulder MRIs (male:female = 259:248; mean age, 55.4 years) were classified into 1) normal type insertion of the pectoralis minor tendon, 2) complete type EIPMT, and 3) partial type EIPMT independently by two radiologists. Inter-observer agreement was calculated using the kappa coefficient. Thickness of the fibrotic scar tissue in the subcoracoid triangle and humeral side axillary recess was measured. MRIs were reviewed by consensus with regard to the grade of fibrotic scar tissue proliferation in the rotator interval. Comparisons were made between normal and EIPMT and between partial and complete type EIPMT. RESULTS: The incidence of EIPMT was 13.4% (complete type, 7.7%; partial type, 5.7%). Inter-observer agreement was substantial (kappa = 0.775). Fibrotic scar tissue in the subcoracoid triangle was thicker, and the grade of fibrotic scar tissue proliferation in the rotator interval was higher in the EIPMT group than those in the control group. No significant difference was observed in the thickness of humeral side axillary recess. The thicknesses of fibrotic scar tissue in the subcoracoid triangle and humeral side axillary recess as well as the grade of fibrotic scar tissue in the rotator interval were not significantly different between complete and partial type EIPMT. CONCLUSION: MRI enabled detection of EIPMT with substantial observer agreement. Patients with EIPMT show a high tendency for fibrotic scar tissue proliferation in the rotator interval.

Morphologic Analysis of Crista Galli Using Computed Tomography

OBJECTIVE: We often observe the variation of Crista galli (CG) which lies in the midline above the cribriform plate on computed tomography (CT) scans. We investigated the variations in CG and the factors which affect its pneumatization. MATERIALS AND METHODS: We analyzed the CT images of 818 chronic rhinosinusitis patients between July 2003 and July 2011. We investigated height, position relative to the cribriform plate, degree of pneumatization, and cell origin for the pneumatization in CG. We analyzed the relationship between several factors (age, sex, and position of CG) and pneumatization of CG. RESULTS: The average height of CG was 17.98 mm. In 13.9% of subjects, the base of CG did not extend below the level of the cribriform plate. In 84.2%, CG extended less than 50% of its height below the cribriform plate. In 1.8%, CG extended more than 50% of its height below the cribriform plate. Pneumatization of CG was found in 12.2%. Except one, every pneumatization was connected with the frontal sinus. The rate of pneumatization was significantly different depending on age. CONCLUSION: Our study demonstrated that CG showed various morphology and pneumatizaiton. The pneumatization of CG was mainly originated from frontal sinus and related to aging.

Fluid Collection in the Right Lateral Portion of the Superior Aortic Recess Mimicking a Right Mediastinal Mass: Assessment with Chest Posterior Anterior and MDCT

OBJECTIVE: We observed patients in whom the fluid collection in the right lateral portion of the superior aortic recess on computed tomography (CT) scans mimicked a right anterior mediastinal mass on chest PA radiographs. The purpose of this study was to assess chest PA and CT features of these patients. MATERIALS AND METHODS: All chest PA radiographs and CT scans in 9 patients were reviewed by two radiologists on a consensus basis; for the presence of pleural effusion, pulmonary edema and heart size on chest PA radiographs. For the portion of the fluid collection in the superior aortic recess (SAR), a connection between the right lateral portion of the SAR (rSAR) and posterior portion of the SAR (pSAR) on CT scans, and the distance between the right lateral margin of the rSAR and the right lateral margin of the superior vena cava. RESULTS: Fluid collection in the rSAR on CT scans caused a right anterior mediastinal mass or a bulging contour on chest PA radiographs in all women patients. All patients showed cardiomegaly, five patients had pleural effusion, and two patients had mild pulmonary edema. Further, eight patients showed a connection between the rSAR and the pSAR. CONCLUSION: The characteristic features of these patients are the right anterior mediastinal mass-like opacity due to fluid collection in the rSAR, are bulging contour with a smooth margin and cardiomegaly regardless of pulmonary edema on the chest PA radiographs, and fluid connection between the rSAR and the pSAR on CT scans.

The Anti-Inflammatory Effects of Statin in 5/6 Nephrectomized Rats / 대한내과학회지

BACKGROUND/AIMS: In a previous study, statin therapy reduced proteinuria and ameliorated the progression of chronic kidney disease. However, in patients with chronic renal failure (CRF), the beneficial effect of statin therapy on the preservation of renal function has not been determined. Thus, we determined the effect of rosuvastatin on CRF. METHODS: Male Sprague-Dawley rats (6 weeks old) were subjected to 5/6 nephrectomy. Six weeks after the procedure, the rats were divided into control and rosuvastatin-treated groups. Body weight and blood/urine biochemical parameters were measured 6 weeks after 5/6 nephrectomy and 8 weeks after the start of rosuvastatin treatment. Remnant kidneys were harvested at 6 (n = 4) and 14 (n = 8) weeks after 5/6 nephrectomy. RESULTS: During rosuvastatin treatment, changes in body weight and serum total and low-density lipoprotein cholesterol did not differ significantly between the control and rosuvastatin-treated groups. Although serum creatinine and proteinuria increased in both groups, the differences were not significant (p = 0.24 and 0.77, respectively). Immunohistochemical staining, enzyme-linked immunosorbent assays, and western blotting showed that the expression of transforming growth factor-beta1 and intracellular adhesion molecule-1 were reduced in the rosuvastatin-treated group. CONCLUSIONS: Long-term statin treatment may attenuate the inflammatory process in the progression of renal failure.

The Anti-Inflammatory Effects of Statin in 5/6 Nephrectomized Rats / 대한내과학회지

BACKGROUND/AIMS: In a previous study, statin therapy reduced proteinuria and ameliorated the progression of chronic kidney disease. However, in patients with chronic renal failure (CRF), the beneficial effect of statin therapy on the preservation of renal function has not been determined. Thus, we determined the effect of rosuvastatin on CRF. METHODS: Male Sprague-Dawley rats (6 weeks old) were subjected to 5/6 nephrectomy. Six weeks after the procedure, the rats were divided into control and rosuvastatin-treated groups. Body weight and blood/urine biochemical parameters were measured 6 weeks after 5/6 nephrectomy and 8 weeks after the start of rosuvastatin treatment. Remnant kidneys were harvested at 6 (n = 4) and 14 (n = 8) weeks after 5/6 nephrectomy. RESULTS: During rosuvastatin treatment, changes in body weight and serum total and low-density lipoprotein cholesterol did not differ significantly between the control and rosuvastatin-treated groups. Although serum creatinine and proteinuria increased in both groups, the differences were not significant (p = 0.24 and 0.77, respectively). Immunohistochemical staining, enzyme-linked immunosorbent assays, and western blotting showed that the expression of transforming growth factor-beta1 and intracellular adhesion molecule-1 were reduced in the rosuvastatin-treated group. CONCLUSIONS: Long-term statin treatment may attenuate the inflammatory process in the progression of renal failure.

MRI Findings of Pericardial Fat Necrosis: Case Report

Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum.

De novo Hyponatremia in Patients Undergoing Peritoneal Dialysis: A 12-month Observational Study / 대한신장학회지

PURPOSE: Hyponatremia occurs infrequently in patients undergoing peritoneal dialysis (PD). Nevertheless, one must understand its pathophysiology, since the therapeutic strategy differs from that of non- PD-related hyponatremia. This study examined the clinical features of hyponatremia in PD and evaluated the factors that may contribute to its development. METHODS: We retrospectively enrolled 51 normonatremic PD patients at Gachon University Gil Hospital, South Korea. Using the plasma sodium levels at month 13, the patients were divided into hyponatremia (Na+ or = 135 mEq/L) groups. Then, the clinical variables of these patients were examined, including peritoneal function and adequacy tests, and biochemical parameters. RESULTS: The de novo hyponatremia (n=8) and normonatremia (n=43) groups had no significant differences in baseline characteristics. At month 1, the serum albumin was lower in the hyponatremia group (p=0.022). In the peritoneal equilibration test analysis, the dialysate-to-plasma ratio for creatinine (D/ P(Cr)) measured after 13 months differed significantly between the two groups (p=0.007), while the maximum dip in sodium did not differ. No significant differences were observed in the normalized protein equivalent of nitrogen appearance, Kt/V, or residual renal function. CONCLUSION: Our data suggest that the development of hyponatremia is associated with a lower initial serum albumin level and increased D/P(Cr) in patients undergoing PD. Therefore, the serum sodium levels should be monitored more carefully in these patients.

The Correlation between Spondyloarthropathy and Peripheral Neuropathy in Chronic Renal Failure Patients Undergoing Hemodialysis

OBJECTIVE: To investigate the relationship between spondyloarthropathy and peripheral neuropathy in spinal pain patient undergoing hemodialysis due to chronic renal failure. METHOD: Subjects were 60 patients complaining posterior neck or back pain, undergoing regular hemodialysis for chronic renal failure. They were divided into two groups according to the radiologic findings: spondyloarthropathy group (SAG, n=28) and no-spondyloarthropathy group (NSAG, n=32). Nerve conduction studies of extremities, simple spinal radiologic examination and bone mineral density at the lumbar spine were taken. RESULTS: Electrodiagnostic study revealed 26 patients (43%) had carpal tunnel syndrome, 32 (53%) had ulnar neuropathy, and 32 (53%) had peripheral polyneuropathy. Carpal tunnel syndrome was more frequent in SAG, but other neuropathic fingings, bone mineral density and duration of hemodialysis were not different between two groups. CONCLUSION: Nerve conduction study could be useful to screen the peripheral neuropathy in patients undergoing hemodialysis due to chronic renal failure. If they complained spinal pain, and diagnosed as spondyloarthropathy by radiologic examination, we might need to do electrodiagnostic study for early detection and treatment of carpal tunnel syndrome.