What is the role of radiography in the diagnosis of amyloid arthropathy?

Updated: May 09, 2019
  • Author: Robert O Holmes, Jr, DO; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Radiography may reveal irregularly shaped hyperlucencies, subchondral cysts, and erosions that will correspond with low-intensity signals on both T1 and T2 MRIs. [91] Ultrasound investigations may also show lucencies, soft-tissue changes, power Doppler changes, increased thickness of tendons, and joint effusions with echogenic zones.

Up to 5% of patients with long-standing RA can develop systemic amyloidosis that usually presents as nephrotic syndrome. [89] Genetic study can predict certain haplotypes that can increase the risk of developing amyloidosis by 7 times. [87] The hope is that this increase in the understanding of haplotypes and proteomics will lead to more specific therapies.

Interestingly, with the advent of more effective therapies for inflammatory arthritis, the incidence of amyloidosis secondary to RA has decreased from 5% to less than 1%. [89]


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