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Polymyalgia rheumatica as the manifestation of unclassified aortitis

Hiroshi Kataoka1, Tatsuya Atsumi, Toko Hashimoto

  • 1Department of Medicine II, Hokkaido University Graduate School of Medicine, Sapporo, Japan. douglas@med.hokudai.ac.jp

Modern Rheumatology
|December 25, 2007
PubMed

Insights

Polymyalgia rheumatica (PMR) can occur with aortitis, even without typical giant cell arteritis (GCA) symptoms. Imaging is recommended to detect this vascular inflammation when PMR is present.

Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Diagnostic Imaging

Background:

  • Polymyalgia rheumatica (PMR) is often associated with giant cell arteritis (GCA).
  • Aortitis, inflammation of the aorta, is a known complication of GCA.
  • Distinguishing PMR with isolated aortitis from GCA can be challenging.

Observation:

  • Two cases of PMR presenting with aortitis were observed.
  • These patients lacked diminished pulses or other common GCA manifestations.
  • Aortitis was identified without significant aortic stenosis.

Findings:

  • Advanced imaging (CT, MRA, FDG-PET) revealed aortitis.
  • The observed aortitis did not fit classifications of established large vessel vasculitides.
  • This suggests aortitis can manifest solely as PMR.

Implications:

  • Aortitis should be considered in the differential diagnosis of PMR, even without GCA signs.
  • Diagnostic imaging plays a crucial role in identifying aortitis in PMR patients.
  • This finding expands the understanding of PMR and associated vasculopathies.

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