Abstract
Pathological hip fractures are associated with substantial morbidity and functional decline. We report a rare case of localized dialysis-related amyloidosis involving both hip joints. A 48-year-old man undergoing long-term hemodialysis presented with atraumatic right hip pain. Radiographs and magnetic resonance imaging revealed a pathological subcapital fracture of the right femoral neck and extensive bilateral femoral neck osteolysis, with amyloid deposition showing low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Given the severe bone erosion and impending fracture of the left femoral neck, bilateral total hip arthroplasty was performed. No evidence of systemic amyloidosis or plasma cell dyscrasia was identified. At one-year follow-up, the patient showed no postoperative complications and regained independent ambulation. This case represents the first reported Korean case of localized dialysis-related amyloidosis affecting both hip joints.