Which physical findings are characteristic of beta-2-microglobulin (beta-2m) amyloidosis?

Updated: Nov 14, 2019
  • Author: Anita Basu, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Systemic involvement is rare in beta-2m amyloidosis. Osteoarticular involvement can include the following:

  • Carpal tunnel syndrome - Patients experience weakness and atrophy of the thenar muscle, along with decreased strength in abduction, opposition, and flexion of the thumb

  • Flexor tenosynovitis - Amyloid deposits may result in prominence of the tendons of the hands on extension; patients often experience decreased digital mobility and soft-tissue swelling over flexor tendon sheaths

  • Scapulohumeral arthropathy - Deposits in and around the rotator cuff may cause soft-tissue thickening around the shoulder, referred to as the shoulder pad sign; the patient's capacity to abduct or internally rotate the arm is limited

  • Spondyloarthropathy - Paravertebral ligaments and intervertebral discs may be destroyed or dislocated, resulting in spinal cord impingement or paraplegia; the cervical spine is most often affected, and patients often present with neck and back pain

  • Bone cysts - Cysts grow in size and number in the wrist, humeral head, hip, and patella; as cysts enlarge, soft-tissue swelling and swollen joints, with subsequent spontaneous tendon rupture and pathologic fracture, may occur (cysts do not regress with renal transplantation)


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