Sonographic evaluation of entheseal sites of the lower extremity in patients undergoing hemodialysis

✍ Scribed by Ulku Kerimoglu; Mutlu Hayran; Fatma Bilge Ergen; Alper Kirkpantur; Cetin Turgan

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 223 KB
• Volume: 35
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.20411

✦ Synopsis

Abstract

Purpose

To evaluate the entheseal sites of the lower extremities in patients on hemodialysis using the Glasgow Ultrasound Enthesitis Scoring System (GUESS) and to correlate the findings with the duration of hemodialysis and patient scores.

Methods

Forty‐nine patients who were on hemodialysis for at least 2 years were grouped according to duration of hemodialysis. Total GUESS scores; total enthesophyte, erosion, and bursitis scores; and tendon thicknesses were calculated, compared between groups, and correlated with duration of dialysis.

Results

There was a statistically significant correlation between duration of hemodialysis and total GUESS score (p < 0.001, r = 0.81) and also between the total enthesophyte and erosion scores (p < 0.001). If severe enthesitis was defined as a total GUESS score of more than 18, receiver operating characteristic (ROC) curve analysis revealed that a cutoff point of 10 years for the duration of hemodialysis would predict severe enthesal damage with 83% sensitivity and 93% specificity (area under the ROC curve, 0.92; 95% confidence interval, 0.83–1.00).

Conclusion

Hemodialysis results in entheseal site changes that worsen with extended duration of hemodialysis, especially after 10 years. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007