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New insights into the role of imaging in polymyalgia rheumatica

Dario Camellino1,2, Christina Duftner3, Christian Dejaco4,5

  • 1Division of Rheumatology, "La Colletta" Hospital, Local Health Trust 3, Arenzano, Italy.

Rheumatology (Oxford, England)
|November 17, 2020
PubMed

Insights

Polymyalgia rheumatica (PMR) diagnosis lacks specific tests. Advanced imaging like FDG-PET/CT offers new insights into PMR inflammation, aiding diagnosis and monitoring, especially for difficult cases.

Area of Science:

  • Rheumatology
  • Medical Imaging

Background:

  • Polymyalgia rheumatica (PMR) is a common inflammatory condition in the elderly.
  • PMR presents with characteristic pain and stiffness in the neck, shoulders, and pelvic girdle.
  • Current diagnostic methods rely on clinical symptoms and non-specific inflammatory markers.

Purpose of the Study:

  • To review novel insights into the pathoanatomy of PMR.
  • To compare the diagnostic values of various imaging techniques for PMR.
  • To summarize the role of imaging in monitoring PMR and predicting outcomes.

Main Methods:

  • Review of recent imaging studies, including ultrasound, MRI, and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) with/without CT.
  • Analysis of imaging findings related to inflammation in PMR, particularly at the hip and spine.
  • Evaluation of imaging's utility in detecting underlying giant cell arteritis (GCA) in specific PMR patient subgroups.

Main Results:

  • Imaging techniques provide novel insights into the anatomical basis of PMR inflammation.
  • FDG-PET/CT may aid in detecting underlying GCA in PMR patients with suboptimal treatment response or relapses.
  • Imaging can help differentiate PMR from other conditions with similar symptoms.

Conclusions:

  • Advanced imaging techniques are increasingly valuable in the diagnosis and management of PMR.
  • Imaging offers a potential to improve diagnostic accuracy and guide treatment strategies for PMR.
  • Further research into imaging modalities can enhance understanding and clinical outcomes for PMR patients.
Keywords:
diagnostic imagingpolymyalgia rheumaticaradionuclide imagingultrasonographyvasculitis

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