Ultrasonic examination of biceps and supraspinatus tendons in patients with chronic hemodialysis, referring to Rasoul Akram Hospital in Tehran at 2019-2020

Introduction: Tendiopathy is defined as an overuse injury that is histologically associated with tenocyte proliferation, collagen fiber degradation, increased non-collagen matrix, fluid accumulation between fibers, capillary proliferation, and calcification. Early diagnosis of tendonopathies Conservative treatments are necessary to prevent severe tendon damage or even rupture. Ultrasound is a new, inexpensive, and affordable way to diagnose tendon lesions, especially in dialysis patients. Therefore, the aim of this study was to evaluate the ultrasonic findings of tendon by then and supraspinatus in chronic hemodialysis patients compared to non-dialysis patients. Methods:  The present study was performed as a case-control study in hemodialysis patients referred to Rasoul Akram Hospital, Tehran. Inclusion criteria included advanced renal failure and regular hemodialysis for at least 6 months three times a week for 4 hours per session. The control group was selected from healthy volunteers. Data were analyzed using SPSS version 22. First, the variables were tested using the Kolmogorov-Smirnov criterion. Quantitative data were expressed as mean ± standard deviation and qualitative data were expressed as frequency and percentage. Significance level was determined at P <0.05. Results: During the study period, 60 people (30 dialysis patients as a patient group and 30 healthy individuals as a control group) who met the inclusion criteria were included in the study. There was no statistically significant difference between the studied groups in terms of age, weight and body mass index. The cross-section of the supraspinatus tendon on the right side was significantly higher in patients than in healthy individuals. The mean elastography of the left biceps tendon in patients was significantly higher than healthy individuals. This difference was also present in the first case of the right supraspinatus tendon. However, there was no significant difference in the next rounds as well as the average value. There was no statistically significant difference between different levels of PTH and tendon thickness and cross section.  In the present study, the elastographic indices of right and left tendon bypass and supraspinatus were not statistically significant in almost all parts of the patient group with the healthy group. This finding confirms the effect of the mentioned factors on the elasticity of the tendon along with its thickness and cross section. In the study of correlation of elastography of tendon bypass and supraspinatus with age, PTH and tendon thickness, it was found that there is no statistically significant relationship between the mentioned variables and elastography. Conclusions: In the present study, ultrasonic indices of different parts of the then tendon and supraspinatus of the right and left sides of patients and the control group were compared with each other. In most cases, these indicators were higher in patients than healthy individuals. This indicated that the tendon thickness was higher in the patient group, which is to be expected. However, an increase in tendon thickness as well as tendon cross-section is also observed in athletes. In other words, exercise can increase the thickness and cross-section of the tendon. Finally, the findings of the study showed that in the patient group, the thickness and cross-sectional area of ​​the right and left tendon bypass and supraspinatus were higher than the control group. Evaluation of Ultra sonographic indices did not show a significant change in tendon elasticity in dialysis patients compared to healthy individuals.