Amyloidosis: A rheumatological perspective on diagnosis, further investigation and treatment

Abstract

In this Grand Round, we present a 58-year-old man with a presumptive diagnosis of rheumatoid arthritis (RA) who was being managed by a plastic surgery unit for a dorsal swelling of his right hand. While awaiting surgery for this lesion, he sustained a pathological fracture of his left neck of femur. This necessitated a total hip joint replacement and pathology revealed amyloidosis. Excision of the hand swelling also revealed amyloidosis as the cause. We discuss the ways in which amyloidosis can mimic musculoskeletal disease as well as the importance and some potential pitfalls of further investigation and management once the diagnosis of amyloidosis has been made. © 2008 Asia Pacific League ..