engleski

Tendon Pathology in Renal Transplant Recipients

PURPOSE: To evaluate morphological changes of the tendons on magnetic resonance imaging (MRI) in renal transplant recipients. METHODS: Renal transplant patients who had a previous long-term peritoneal dialysis or hemodialysis underwent MRI of the various regions of the musculoskeletal system. A total of 19 regions (6 hips, 5 Achilles tendons, 4 knees, 4 shoulders) in 15 patients were analyzed. The control group included patients with normal renal function, appropriate age and sex, who underwent MRI of the same regions without a history of trauma or inflammatory disease. RESULTS: We found morphological changes of the tendons in all renal transplant recipients. All recipients who underwent shoulder MRI had rotator cuff tendinopathy, two patients had a partial-thickness tear of supraspinatus tendon and one patient had a complete tear of both supraspinatus and infraspinatus tendons. All recipients who underwent hips MRI had gluteal tendinopathy. Among recipients who underwent knee MRI one patient had a partial-thickness tear of the quadriceps femoris tendon, two patients had patellar tendinopathy and one patient had both quadriceps femoris tendon partial tear and patellar tendinopathy. All five recipients who underwent Achilles tendon/s MRI had tendinopathy, one of them had changes bilaterally and one of them had partial-thickness tear of Achilles tendon. In the control group of patients, the morphological changes of the tendons were found in 30% of patients. Two patients had a mild supraspinatus tendinopathy and one patient had both supraspinatus and subscapularis tendinopathy without tear. In one patient gluteal tendinopathy was found and one patient had signs of Achilles tendinopathy without tear. CONCLUSION: Renal transplant patients are at higher risk of developing of tendinopathy and spontaneous tendon tears in comparison to the control group. Such changes are primarily due to a large number of medications that transplant patients receive, primarily immunomodulators and immunosuppressants. It is also known that hyperparathyroidism and dialysis before transplantation may lead to structural changes in muscles and tendons.

tendon; pathology; MRI; renal transplantation

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