Abstract: Objective To evaluate the usefulness of high frequency ultrasonography of sternoclavicular (SC) joint for the diagnosis of dialysis-related amyloidosis (DRA). Methods Sixty-eight maintenance hemodialysis (MHD) patients and forty normal individuals as the controls were enrolled in this study. MHD patients
were then subdivided into three groups by MHD duration: group I ≤5 years, group II 5～10 years and group III ＞10 years. Ultrasonography of the SC joint was performed bilaterally for patients and controls. The maximum distance (D) between anterior periosterum surface of clavicle and the outer edge of joint capsule and the smoothness of the articular surface were determined by high frequency ultrasonography. D value ＞2mm at any side was defined as a positive finding. Serum β₂ microglobulin (β₂-M) level was measured at the same time. Results D value of SC joint was significantly higher in MHD patients than in normal controls, and was also significantly different among the four groups (right, F=16.895, P＜0.001; left, F=19.812, P＜0.001). There was no different between left side and right side (P＞0.05). The positive rate of SC joint was 5% in control group, 50.0% in group I, 61.5% in group II and 86.4% in group III (χ²=43.628, P＜0.001), indicating a correlation between D value and hemodialysis duration (r=0.412, P＜0.05). Serum β₂-M was significantly higher than the normal value in MHD patients. There was no significant difference in serum β2-M among the three groups of MHD patients (F=1.855, P=0.167). Conclusions The capsule and synovium of the SC joint become thicker as the dialysis duration prolonged. High frequency ultrasonography of SC joint is a less expensive and noninvasive method for the early diagnosis and fellow-up of DRA.

Key words: Sternoclavicular joint, Hemodialysis, Amyloidosis