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Related Experiment Videos

Joint imaging in polymyalgia rheumatica

J D O'Duffy, H W Wahner, G G Hunder

    Mayo Clinic Proceedings
    |August 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

    Technetium pertechnetate scintigraphy reveals common synovitis in polymyalgia rheumatica, often affecting shoulders. This imaging technique helps differentiate it from other rheumatic conditions.

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    Area of Science:

    • Rheumatology
    • Nuclear Medicine
    • Immunology

    Background:

    • Polymyalgia rheumatica (PMR) is a common inflammatory condition.
    • The underlying pathology of PMR, particularly the presence of synovitis, remains debated.
    • Distinguishing PMR from other arthritic conditions like rheumatoid arthritis (RA) is clinically important.

    Purpose of the Study:

    • To evaluate the utility of technetium pertechnetate joint scintigraphy in diagnosing polymyalgia rheumatica.
    • To investigate the pattern and prevalence of synovitis in PMR patients.
    • To compare scintigraphic findings in PMR with those in rheumatoid arthritis and nonarticular rheumatism.

    Main Methods:

    • Technetium pertechnetate scintigraphy was performed on patients with polymyalgia rheumatica (PMR), rheumatoid arthritis (RA), nonarticular rheumatism, and healthy controls.

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  • Scintigraphic findings, including uptake patterns and symmetry, were analyzed.
  • Correlation between scintigraphic abnormalities, clinical symptoms, and physical findings was assessed.
  • Biopsies were obtained in select cases.

    • Main Results:

    • Abnormal scintigrams were observed in 24/25 PMR patients, 16/16 RA patients, and 4/13 nonarticular rheumatism patients, but none of the 26 controls.
    • Shoulder involvement was most common in PMR, with less symmetry than in RA, where distal joints predominated.
    • Abnormal uptake correlated with symptoms (72%) and physical abnormalities (81%).
    • Lymphocytic synovitis was confirmed on biopsy in one PMR patient.

    Conclusions:

    • Synovitis is a common finding in polymyalgia rheumatica, as detected by technetium pertechnetate scintigraphy.
    • Joint scintigraphy can aid in the diagnosis and understanding of PMR pathology.
    • The imaging findings suggest that synovitis may be a primary contributor to symptoms in PMR.