[Pathologic fractures in dialysis-associated amyloidosis].

A correlation could be demonstrated between four pathological femoral neck fractures in patients who regularly underwent hemodialysis; cystic bone deposits of beta-2-microglobulin amyloid were also found. The characteristic symptom complex includes painful arthralgia of the shoulder, carpal tunnel syndrome, pain in the hip and recurrent knee effusions. The first step in the diagnostic procedure is to demonstrate cystic defects in skeletal radiographs. Then a biopsy of the cystic bone lesion is needed for histological verification of beta-2-microglobulin. The surgical treatment is total joint replacement or augmented composite osteosynthesis due to poor regeneration capacity in the amyloid bone lesion.