INTRODUCTION: Polymyalgia rheumatica (PMR) is an inflammatory disorder that affects the elderly. At present, evidence is limited regarding the usefulness of positron emission tomography-computed tomography (PET-CT) in the diagnosis of PMR. This study aimed to compare patient characteristics and symptoms with PET-CT findings in a Danish population of PMR patients without clinical symptoms of giant cell arteritis. METHODS: The medical records of 50 Danish PET-CT-scanned patients with PMR were reviewed. Symptoms, characteristics and PET-CT findings were registered from the medical records. RESULTS: Fluorodeoxyglucose (FDG) uptake was seen at the shoulders and/or hips of about 80%, and at the spinous processes of about 50% of the patients. Furthermore, 14% of the patients showed no FDG uptake at any of the studied locations. A sensitivity of 79% for PMR was found if there was FDG uptake at any two of the following three locations: the shoulder, the hip and the spinous processes. Vascular FDG uptake was seen in 7% of the patients. No significant correlations between any symptoms and any PET-CT findings were found. C-reactive protein level was significantly lower in patients receiving glucocorticoids, and completely normal scans were seen significantly more often in patients receiving steroid treatment. CONCLUSIONS: PET-CT is a sensitive imaging technique in PMR patients. Symptoms and PET-CT findings do not correlate in PMR. Steroid treatment prior to PET-CT reduces the scan's ability to demonstrate inflammation in PMR patients. FUNDING: none. TRIAL REGISTRATION: not relevant. Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
INTRODUCTION:Polymyalgia rheumatica (PMR) is an inflammatory disorder that affects the elderly. At present, evidence is limited regarding the usefulness of positron emission tomography-computed tomography (PET-CT) in the diagnosis of PMR. This study aimed to compare patient characteristics and symptoms with PET-CT findings in a Danish population of PMR patients without clinical symptoms of giant cell arteritis. METHODS: The medical records of 50 Danish PET-CT-scanned patients with PMR were reviewed. Symptoms, characteristics and PET-CT findings were registered from the medical records. RESULTS:Fluorodeoxyglucose (FDG) uptake was seen at the shoulders and/or hips of about 80%, and at the spinous processes of about 50% of the patients. Furthermore, 14% of the patients showed no FDG uptake at any of the studied locations. A sensitivity of 79% for PMR was found if there was FDG uptake at any two of the following three locations: the shoulder, the hip and the spinous processes. Vascular FDG uptake was seen in 7% of the patients. No significant correlations between any symptoms and any PET-CT findings were found. C-reactive protein level was significantly lower in patients receiving glucocorticoids, and completely normal scans were seen significantly more often in patients receiving steroid treatment. CONCLUSIONS: PET-CT is a sensitive imaging technique in PMR patients. Symptoms and PET-CT findings do not correlate in PMR. Steroid treatment prior to PET-CT reduces the scan's ability to demonstrate inflammation in PMR patients. FUNDING: none. TRIAL REGISTRATION: not relevant. Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
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Authors: K S M van der Geest; G Treglia; A W J M Glaudemans; E Brouwer; F Jamar; R H J A Slart; O Gheysens Journal: Eur J Nucl Med Mol Imaging Date: 2020-12-28 Impact factor: 9.236
Authors: Kornelis S M van der Geest; Yannick van Sleen; Pieter Nienhuis; Maria Sandovici; Nynke Westerdijk; Andor W J M Glaudemans; Elisabeth Brouwer; Riemer H J A Slart Journal: Rheumatology (Oxford) Date: 2022-03-02 Impact factor: 7.580