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Determining Glucose Metabolism Kinetics Using 18F-FDG Micro-PET/CT
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Predictors of positive 18F-FDG PET/CT-scan for large vessel vasculitis in patients with persistent polymyalgia

Diana Prieto-Peña1, Isabel Martínez-Rodríguez2, Javier Loricera1

  • 1Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.

Seminars in Arthritis and Rheumatism
|June 16, 2018
PubMed
Abstract

Insights

Polymyalgia rheumatica (PMR) can indicate giant cell arteritis (GCA). Specific pains like lower limb, pelvic girdle, and low back pain predict positive PET/CT scans for large vessel vasculitis in PMR patients.

Area of Science:

  • Rheumatology
  • Nuclear Medicine
  • Vascular Imaging

Background:

  • Polymyalgia rheumatica (PMR) frequently presents as an initial symptom of giant cell arteritis (GCA).
  • Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) scans are valuable for detecting large vessel vasculitis (LVV) in PMR patients.

Purpose of the Study:

  • To identify predictors of a positive PET/CT scan for LVV in patients diagnosed with isolated Polymyalgia Rheumatica.
  • To refine diagnostic strategies for differentiating PMR from GCA-related vasculitis.

Main Methods:

  • Retrospective analysis of 84 patients with classic PMR who underwent PET/CT scans.
  • Exclusion of patients with PMR associated with other conditions or cranial GCA features.
  • Statistical analysis to determine predictors of positive PET/CT scans for LVV.

Main Results:

  • 60.7% of classic PMR patients had positive PET/CT scans for LVV.
  • Bilateral diffuse lower limb pain (OR=8.8), pelvic girdle pain (OR=4.9), and inflammatory low back pain (OR=4.7) were significant predictors.
  • Unusual symptoms were more common in patients with positive PET/CT scans.

Conclusions:

  • Inflammatory low back pain, pelvic girdle pain, and diffuse lower limb pain are key predictors of positive PET/CT scans for LVV in PMR.
  • These findings aid in identifying PMR patients who may have underlying large vessel vasculitis.
Keywords:
Giant cell arteritisLarge vessel vasculitisPET/CT scanPolymyalgia rheumaticaPredictors

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