Knee ultrasonography in end stage kidney disease patients

Aim of the work

To detect ultrasonographic findings in the knees of end stage kidney disease (ESKD) patients on regular hemodialysis.

Patients and methods

Thirty adult ESKD patients on regular hemodialysis for more than one year were studied. Patients with gout, knee joint replacement or injection with steroids were excluded. Knee ultrasonography was done to evaluate the femoral cartilage as regards its thickness, sharpness or urate crystal deposition.

Results

This study included 13 male (43.3 %) and 17 females (56.7 %) with mean age 45 ± 12 years, body mass index (BMI) 26.4 ± 5.4 Kg/m2, duration of hemodialysis 1.5–27 years and serum uric acid 3.6 (1–10). Femoral cartilage double contour sign was present in 11 (36.7 %) patients, suprapatellar effusion in 20 (66.7 %), suprapatellar aggregates in 10 (33.3 %), medial patellar effusion in 8 (26.7 %), lateral patellar effusion in 12 (40 %) and lateral patellar aggregate was in 6 (20 %). Serum uric acid (SUA) level tended to correlate with body mass index (BMI), total cholesterol, LDL, fasting blood sugar (FBS), and platelet counts without significance and negatively correlated to age, hemoglobin (Hb) level, total leucocytic count (TLC), size of suprapatellar effusion and duration of hemodialysis.

Conclusion

Effusion, urate crystal deposition, double contour and aggregate were frequently observed in knee ultrasound in ESRD patients on hemodialysis. Both double contour and aggregates were the most common combined ultrasound finding. The ultrasonographic findings were not related to the duration of hemodialysis or uric acid level.