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Proximal bursitis in active polymyalgia rheumatica

C Salvarani1, F Cantini, I Olivieri

  • 1Unità Reumatologica, Azienda Ospedaliera Arciapedale S. Maria Nuova, Reggio Emilis, Italy.

Annals of Internal Medicine
|July 1, 1997
PubMed
Summary
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Polymyalgia rheumatica patients show increased bursitis in the shoulder, suggesting inflammation of bursae contributes to their pain. This study investigated shoulder structures in polymyalgia rheumatica (PMR) patients.

Area of Science:

  • Rheumatology
  • Musculoskeletal Disorders
  • Medical Imaging

Background:

  • The etiology of proximal extremity musculoskeletal symptoms in polymyalgia rheumatica (PMR) remains unclear.
  • Mild joint synovitis observed in PMR patients does not fully account for their severe discomfort.

Purpose of the Study:

  • To investigate the involvement of synovial structures in the shoulder girdle of patients experiencing active polymyalgia rheumatica symptoms.

Main Methods:

  • A case-control study was conducted involving 13 PMR patients, 9 elderly-onset rheumatoid arthritis patients, and 10 healthy controls.
  • Magnetic resonance imaging (MRI) of the shoulder was performed on all participants.

Main Results:

  • Subacromial and subdeltoid bursitis occurred significantly more often in PMR patients compared to rheumatoid arthritis controls.

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  • No significant differences in joint synovitis or biceps tenosynovitis were found between PMR and rheumatoid arthritis groups.
  • Healthy controls exhibited no signs of fluid accumulation in joints, bursae, or biceps sheaths.

    • Conclusions:

    • Inflammation of the subacromial and subdeltoid bursae, along with glenohumeral joint synovitis and biceps tenosynovitis, likely contributes to shoulder girdle pain in polymyalgia rheumatica patients.