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MRI findings of the shoulder and hip joint in patients with polymyalgia rheumatica
Junko Ochi1, Taiki Nozaki, Masato Okada
1a Department of Radiology , St. Luke's International Hospital , Tokyo , Japan.
Objectives:
The purpose of this study is to evaluate magnetic resonance imaging (MRI) findings of the shoulder and hip joint in patients with polymyalgia rheumatica (PMR).
Methods:
MR images of a total of 25 PMR patients (23 shoulders and 6 hips), 43 rheumatoid arthritis (RA) patients (22 shoulders and 22 hips), and 50 control patients (25 shoulders and 25 hips) were examined. The following MRI findings were evaluated: In the shoulder, thickness and abnormalities of the supraspinatus tendon, effusion around the glenohumeral joint, subacromial-subdeltoid bursa, and the biceps tendon; In the hip, effusion around the acetabulofemoral joint, iliopsoas bursa, and trochanteric bursa. Periarticular soft-tissue edema and bone findings were also analyzed.
Results:
The supraspinatus tendon was significantly thicker in PMR patients than in RA patients and control patients (p < 0.05). Severe rotator cuff tendinopathy was frequently observed in PMR patients (p = 0.002). The scores for the amount of effusions (joint, bursa, and tendon sheath in the shoulder and bursa in the hip) were much higher in PMR patients (p < 0.05). Periarticular soft tissue edema was detected more frequently in PMR patients than in RA patients and control patients (p < 0.05).
Conclusions:
Thick supraspinatus tendon, severe rotator cuff tendinopathy, effusion around the joints, and periarticular soft tissue edema can be good indicators for the diagnosis of PMR.
Insights
Magnetic resonance imaging (MRI) reveals thickened supraspinatus tendons and rotator cuff tendinopathy in polymyalgia rheumatica (PMR) patients. These findings, along with joint effusions and soft tissue edema, aid in diagnosing PMR.
Area of Science:
- Rheumatology
- Radiology
- Medical Imaging
Background:
- Polymyalgia rheumatica (PMR) is an inflammatory condition affecting older adults.
- Distinguishing PMR from other inflammatory arthropathies can be challenging.
- Magnetic resonance imaging (MRI) offers detailed visualization of musculoskeletal structures.
Purpose of the Study:
- To evaluate specific MRI findings in the shoulder and hip joints of patients diagnosed with polymyalgia rheumatica (PMR).
- To identify imaging biomarkers that can assist in the diagnosis of PMR.
Main Methods:
- Retrospective analysis of MRI scans from 25 PMR patients, 43 rheumatoid arthritis (RA) patients, and 50 controls.
- Assessment of shoulder MRI findings including supraspinatus tendon thickness/abnormalities, glenohumeral joint effusion, and bursal/biceps tendon involvement.
- Evaluation of hip MRI findings including acetabulofemoral joint effusion, and iliopsoas/trochanteric bursal involvement.
- Analysis of periarticular soft tissue edema and bone findings in all groups.
Main Results:
- PMR patients exhibited significantly thicker supraspinatus tendons compared to RA patients and controls (p < 0.05).
- Severe rotator cuff tendinopathy was more prevalent in PMR patients (p = 0.002).
- Increased effusions in joints, bursae, and tendon sheaths were observed in PMR patients (p < 0.05).
- Periarticular soft tissue edema was more frequent in PMR patients than in RA patients and controls (p < 0.05).
Conclusions:
- A thickened supraspinatus tendon is a key MRI finding in PMR.
- Severe rotator cuff tendinopathy, joint effusions, and periarticular soft tissue edema are significant indicators for PMR diagnosis.
- MRI findings can serve as valuable diagnostic aids for polymyalgia rheumatica.
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