Amyloidosis of the hip. Presentation of a case and a review of the literature

Abstract Introduction The term amyloidosis has been applied to a group of diseases which produce a deposit of extracellular material in organs and tissues. The joint symptoms appear due to the destruction process, with the development of erosions and significant joint effusions. The diagnosis and treatment of amyloidosis are based on histopathological and immunohistochemical studies of the amyloid deposits. Clinical case We present the case of a 58 year-old male, with a history of peritoneal dialysis 15 years ago and currently on haemodialysis treatment. He came to our clinic complaining of inguinal pain which began a year ago and was refractory to analgesic treatment. The radiology study showed a massive destruction of the coxofemoral joint. The study was extended by using magnetic resonance, which showed the presence of erosions with a sclerosing border in the iliac region and the presence of an abundant joint effusion; data suggestive of an erosive inflammatory arthritis associated with an infectious process or amyloid deposit. A joint biopsy using open surgery enabled the diagnosis of hip amyloidosis to be made using Congo red stain. After ruling out a septic process, it was decided to perform a hip replacement. Conclusion Amyloidosis mainly in the bone and joint is an uncommon manifestation of this disease; the diagnostic suspicion is fundamental to be able to direct the histopathologist to its definitive diagnosis, since these stains are not used routinely.