Clinical and ultrasonographic features of 104 knee joints in hemodialysis patients: impact of age, gender, and hemodialysis duration: a descriptive cross-sectional study

Abstract Background and objectives Hemodialysis (HD) patients struggle with musculoskeletal disorders. This study aimed to examine knee clinical and musculoskeletal ultrasonographic (MSUS) characteristics in HD patients and to evaluate the influence of age, gender, and HD duration. Materials and met...

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Main Authors: Samar Tharwat, Marwa Saleh, Rabab Elrefaey, Mona Kamal Nassar, Mohammed Kamal Nassar
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08447-9
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author Samar Tharwat
Marwa Saleh
Rabab Elrefaey
Mona Kamal Nassar
Mohammed Kamal Nassar
author_facet Samar Tharwat
Marwa Saleh
Rabab Elrefaey
Mona Kamal Nassar
Mohammed Kamal Nassar
author_sort Samar Tharwat
collection DOAJ
description Abstract Background and objectives Hemodialysis (HD) patients struggle with musculoskeletal disorders. This study aimed to examine knee clinical and musculoskeletal ultrasonographic (MSUS) characteristics in HD patients and to evaluate the influence of age, gender, and HD duration. Materials and methods This cross-sectional descriptive study included 52 patients (104 knee joints) on regular HD for at least 6 months. Demographic, clinical, therapeutic, and laboratory data were collected. Chronic knee pain was assessed for duration, intensity, and laterality. Swelling, crepitus, and tenderness were assessed in both knees. EULAR-standardized knee MSUS evaluations were performed on all patients. The patients were then compared based on age, gender, and HD duration. Results The mean age of the patients was 52.4 ± 14.15 years, with 25 females and 27 males, median duration of HD was 3.5 years. Chronic knee pain was present in 31 of 104 knees (29.8%). The scanned 104 knee joints had at least one MSUS finding in 91 (87.5%): suprapatellar effusion in 57 (54.8%), synovial thickening in 13 (12.5%), abnormal cartilage morphology in 68 (65.4%), quadriceps tendon abnormalities in 58 (55.8%), patellar tendon abnormalities in 34 (32.7), medial meniscus abnormalities in 30 (28.8%), lateral meniscus abnormalities in 13 (12.5%), and Baker cyst in 5 (4.8%). MSUS abnormalities were significantly more prevalent in HD patients older than 40 years (94.9% vs. 65.4; p < 0.001). Chronic Knee Pain was more prevalent in females than males (40% versus 20%, respectively). Regarding HD duration, quadriceps, and patellar tendons exhibited more MSUS abnormalities in patients with HD duration > 3 years (86.5% vs. 42.0% and 38.9% vs. 25%, respectively) compared to others. Conclusion MSUS findings of the knee are prevalent among HD patients, particularly those of female gender, older age, and longer duration of HD. These findings could be subclinical. Typically, the severity of suprapatellar effusion is related to additional structural abnormalities.
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spelling doaj-art-d48f6a76ada54a3bafa2f6ff03a9af712025-08-20T03:01:54ZengBMCBMC Musculoskeletal Disorders1471-24742025-03-0126111110.1186/s12891-025-08447-9Clinical and ultrasonographic features of 104 knee joints in hemodialysis patients: impact of age, gender, and hemodialysis duration: a descriptive cross-sectional studySamar Tharwat0Marwa Saleh1Rabab Elrefaey2Mona Kamal Nassar3Mohammed Kamal Nassar4Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura UniversityMansoura Nephrology & Dialysis Unit (MNDU), Department of Internal Medicine, Faculty of Medicine, Mansoura UniversityMansoura Nephrology & Dialysis Unit (MNDU), Department of Internal Medicine, Faculty of Medicine, Mansoura UniversityDepartment of Radiology, Student Hospital, Mansoura UniversityDepartment of Internal Medicine, Faculty of Medicine, Horus UniversityAbstract Background and objectives Hemodialysis (HD) patients struggle with musculoskeletal disorders. This study aimed to examine knee clinical and musculoskeletal ultrasonographic (MSUS) characteristics in HD patients and to evaluate the influence of age, gender, and HD duration. Materials and methods This cross-sectional descriptive study included 52 patients (104 knee joints) on regular HD for at least 6 months. Demographic, clinical, therapeutic, and laboratory data were collected. Chronic knee pain was assessed for duration, intensity, and laterality. Swelling, crepitus, and tenderness were assessed in both knees. EULAR-standardized knee MSUS evaluations were performed on all patients. The patients were then compared based on age, gender, and HD duration. Results The mean age of the patients was 52.4 ± 14.15 years, with 25 females and 27 males, median duration of HD was 3.5 years. Chronic knee pain was present in 31 of 104 knees (29.8%). The scanned 104 knee joints had at least one MSUS finding in 91 (87.5%): suprapatellar effusion in 57 (54.8%), synovial thickening in 13 (12.5%), abnormal cartilage morphology in 68 (65.4%), quadriceps tendon abnormalities in 58 (55.8%), patellar tendon abnormalities in 34 (32.7), medial meniscus abnormalities in 30 (28.8%), lateral meniscus abnormalities in 13 (12.5%), and Baker cyst in 5 (4.8%). MSUS abnormalities were significantly more prevalent in HD patients older than 40 years (94.9% vs. 65.4; p < 0.001). Chronic Knee Pain was more prevalent in females than males (40% versus 20%, respectively). Regarding HD duration, quadriceps, and patellar tendons exhibited more MSUS abnormalities in patients with HD duration > 3 years (86.5% vs. 42.0% and 38.9% vs. 25%, respectively) compared to others. Conclusion MSUS findings of the knee are prevalent among HD patients, particularly those of female gender, older age, and longer duration of HD. These findings could be subclinical. Typically, the severity of suprapatellar effusion is related to additional structural abnormalities.https://doi.org/10.1186/s12891-025-08447-9Musculoskeletal ultrasoundKneeHemodialysisKnee effusion
spellingShingle Samar Tharwat
Marwa Saleh
Rabab Elrefaey
Mona Kamal Nassar
Mohammed Kamal Nassar
Clinical and ultrasonographic features of 104 knee joints in hemodialysis patients: impact of age, gender, and hemodialysis duration: a descriptive cross-sectional study
BMC Musculoskeletal Disorders
Musculoskeletal ultrasound
Knee
Hemodialysis
Knee effusion
title Clinical and ultrasonographic features of 104 knee joints in hemodialysis patients: impact of age, gender, and hemodialysis duration: a descriptive cross-sectional study
title_full Clinical and ultrasonographic features of 104 knee joints in hemodialysis patients: impact of age, gender, and hemodialysis duration: a descriptive cross-sectional study
title_fullStr Clinical and ultrasonographic features of 104 knee joints in hemodialysis patients: impact of age, gender, and hemodialysis duration: a descriptive cross-sectional study
title_full_unstemmed Clinical and ultrasonographic features of 104 knee joints in hemodialysis patients: impact of age, gender, and hemodialysis duration: a descriptive cross-sectional study
title_short Clinical and ultrasonographic features of 104 knee joints in hemodialysis patients: impact of age, gender, and hemodialysis duration: a descriptive cross-sectional study
title_sort clinical and ultrasonographic features of 104 knee joints in hemodialysis patients impact of age gender and hemodialysis duration a descriptive cross sectional study
topic Musculoskeletal ultrasound
Knee
Hemodialysis
Knee effusion
url https://doi.org/10.1186/s12891-025-08447-9
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