[A case of polymyalgia rheumatica where a complication of large-vessel vasculitis was diagnosed by FDG-PET]

Related Experiment Video

Updated: Jun 23, 2026

Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT)
10:02

Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT)

Published on: May 2, 2012

Tomohiko Shibata1, Toshiko Shibata, Shoichi Ozaki

  • 1Division of Rheumatology and Allergy Department of Internal Medicine, St. Marianna University School of Medicine.

Nihon Rinsho Men'Eki Gakkai Kaishi = Japanese Journal of Clinical Immunology
|May 1, 2009
PubMed

Insights

This case highlights elderly polymyalgia rheumatica (PMR) patients potentially developing large-vessel giant cell arteritis (LV-GCA). 18F-FDG-PET imaging aids in diagnosing this serious complication when typical symptoms are absent.

Area of Science:

  • Rheumatology
  • Nuclear Medicine
  • Vascular Medicine

Background:

  • Polymyalgia rheumatica (PMR) is an inflammatory condition typically affecting older adults.
  • Giant cell arteritis (GCA) is a vasculitis that can affect large arteries.
  • Diagnosing GCA in PMR patients can be challenging without classic temporal artery findings.

Observation:

  • A 74-year-old female with PMR presented with fever and myalgia.
  • Physical examination revealed no temporal artery abnormalities.
  • 18F-FDG-PET showed inflammation in the aorta and subclavian arteries.

Findings:

  • Magnetic resonance angiography confirmed stenosis in the subclavian arteries, indicative of angitis.
  • The patient was diagnosed with PMR and co-existing large-vessel giant cell arteritis (LV-GCA).
  • Treatment with prednisolone effectively resolved symptoms.

Implications:

  • 18F-FDG-PET is a valuable tool for detecting large-vessel inflammation in suspected GCA, especially when temporal artery involvement is absent.
  • Early diagnosis and treatment of LV-GCA in PMR patients are crucial to prevent complications.
  • This case underscores the importance of considering LV-GCA in elderly PMR patients with atypical presentations.

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