Sonographic Evaluation of Lower-limbs Entheses in Subclinical Patients Undergoing Hemodialysis

林 正輝(Cheng-Hui Lin), 項 正川(Jeng-Chuan Shiang), 蔡 明凱(Ming-Kai Tsai), 張 棋楨(Chi-Ching Chang), 張 德明(Deh-Ming Chang)

Research output: Contribution to journalArticle


Objective: To survey the prevalence of entheseal abnormality in the lower limbs in subclinical patients undergoing hemodialysis by musculoskeletal ultrasound (MSUS), rate the severity of abnormalities using the Glasgow Ultrasound Enthesitis Scoring system (GUESS), and correlate the score with other clinical factors.Methods: Forty-eight subclinical patients who had undergone hemodialysis for at least 4 months were divided into 2 groups. The groups were compared for the total GUESS score, thickness score, erosion score, enthesophyte score, and bursitis score. We then assessed the correlations between these scores and the duration of dialysis, sex, age, body mass index (BMI), and levels of serum biomarkers.Results: The duration of hemodialysis was found to be significantly correlated with the total GUESS score (p<0.001, r = 0.88) and enthesophyte score (p<0.001, r = 0.71). No significant correlation was detected between the scores and the following variables: age; sex; BMI; calcium-phosphorus product; and serum levels of calcium, phosphorous, parathormone, uric acid, triglycerides, cholesterol, and C-reactive protein. The prevalence of bilateral lower limb enthesopathy, determined on the basis of grayscale musculoskeletal ultrasound examination, was 21.8%.Conclusion: Hemodialysis patients may develop lower limb enthesopathy, which worsens with increase in the duration of hemodialysis, even in the absence of obvious clinical symptoms or signs. MSUS should be more widely employed by clinicians for the early diagnosis of enthesopathy in subclinical hemodialysis patients.
Original languageEnglish
Pages (from-to)41-48
Number of pages8
JournalFormosan Journal of Rheumatology
Issue number1&2
Publication statusPublished - 2012



  • 血液透析
  • 接骨點病變
  • Musculoskeletal ultrasound
  • enthesopathy
  • hemodialysis

Cite this

林正輝(Cheng-Hui L, 項正川(Jeng-Chuan S, 蔡明凱(Ming-Kai T, 張棋楨(Chi-Ching C, & 張德明(Deh-Ming C (2012). Sonographic Evaluation of Lower-limbs Entheses in Subclinical Patients Undergoing Hemodialysis. Formosan Journal of Rheumatology, 26(1&2), 41-48.