[Destructive spondylopathy in the dialysis patient. The diagnostic role of magnetic resonance].

Magnetic resonance imaging (MRI) was employed to study 7 long-term hemodialysis patients affected with destructive amyloid spondyloarthropathy. In the appropriate clinical setting, MRI proved to be more useful than conventional radiography or CT and more definitive in excluding infections. Indeed, MRI can replace more invasive procedures in making the correct diagnosis. Different than what is reported in literature, a high incidence of odontoid lesions (C2) was observed in our series, with extraosseous and extradural deposits of soft tissue masses (amyloid pseudotumors), subluxation, odontoid invagination and medullary compression. Bone lesions, involved disks and amyloid pseudotumors typically exhibited low-intensity signal on both T1- and T2-weighted sequences and no enhancement following Gd-DTPA injection. The use of MRI is thus suggested, especially at cervical level, also in case of relatively mild symptoms.