18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study
Abstract Background Various inflammatory conditions may present with musculoskeletal symptoms similar to those of polymyalgia rheumatica (PMR). We investigated findings on 18F-fluorodexoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) images that may differentiate PMR from p...
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doaj-1f999b8023d148bc82cf68749686c0662020-11-25T02:34:37ZengBMCBMC Rheumatology2520-10262020-04-01411610.1186/s41927-020-00121-y18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective studyHideyuki Horikoshi0Takashi Nakanishi1Katsumi Tamura2Fumihiko Kimura3Kenji Itoh4Division of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical CollegeDivision of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical CollegeTokorozawa PET Diagnostic Imaging ClinicDivision of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical CollegeDivision of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical CollegeAbstract Background Various inflammatory conditions may present with musculoskeletal symptoms similar to those of polymyalgia rheumatica (PMR). We investigated findings on 18F-fluorodexoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) images that may differentiate PMR from polymyalgia-like illnesses. Methods We analyzed data from 25 patients with new-onset polymyalgia-like illnesses who fulfilled Bird’s diagnostic criteria for PMR and had undergone FDG–PET/CT scan. To assess the uptake by major joints and synovial bursae, particularly at PMR-specific sites (shoulder, sternoclavicular, and hip joints, interspinous bursae, ischial tuberosities, and greater trochanters), we used visual scoring system to score FDG uptake: 0, no uptake (same as bone); 1, slight uptake; 2, moderate uptake (same as the liver); 3, greater uptake than the liver; and 4, uptake as strong as in the cerebellum. Results The final diagnoses were PMR in 17 patients and non-PMR in eight patients (three malignancies, two infections, one cholesterol crystal embolism, one ANCA-associated vasculitis, and one undefined diagnosis). Although the serum MMP-3 levels were significantly higher in patients with PMR, C-reactive protein and erythrocyte sedimentation rate mean values did not differ between the two groups. In PMR-specific sites, FDG accumulations were observed in all cases of PMR, with a high PET-positive score of 2.00 (range, 0–3), but it was low in non-PMR cases, with a PET-positive score of 1.00 (range, 0–3). Conclusions The FDG accumulation patterns in polymyalgia-like illness differ from those in PMR, despite the similar clinical presentations of both conditions. An FDG–PET/CT scan is useful for differentiating PMR from other polymyalgia-like illnesses.http://link.springer.com/article/10.1186/s41927-020-00121-yPolymyalgia-like illnessPolymyalgia rheumaticaFDG–PET/CT |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hideyuki Horikoshi Takashi Nakanishi Katsumi Tamura Fumihiko Kimura Kenji Itoh |
spellingShingle |
Hideyuki Horikoshi Takashi Nakanishi Katsumi Tamura Fumihiko Kimura Kenji Itoh 18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study BMC Rheumatology Polymyalgia-like illness Polymyalgia rheumatica FDG–PET/CT |
author_facet |
Hideyuki Horikoshi Takashi Nakanishi Katsumi Tamura Fumihiko Kimura Kenji Itoh |
author_sort |
Hideyuki Horikoshi |
title |
18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study |
title_short |
18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study |
title_full |
18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study |
title_fullStr |
18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study |
title_full_unstemmed |
18F-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study |
title_sort |
18f-fluorodeoxyglucose–positron emission tomography/computed tomography for the diagnosis of polymyalgia-like illnesses: a retrospective study |
publisher |
BMC |
series |
BMC Rheumatology |
issn |
2520-1026 |
publishDate |
2020-04-01 |
description |
Abstract Background Various inflammatory conditions may present with musculoskeletal symptoms similar to those of polymyalgia rheumatica (PMR). We investigated findings on 18F-fluorodexoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) images that may differentiate PMR from polymyalgia-like illnesses. Methods We analyzed data from 25 patients with new-onset polymyalgia-like illnesses who fulfilled Bird’s diagnostic criteria for PMR and had undergone FDG–PET/CT scan. To assess the uptake by major joints and synovial bursae, particularly at PMR-specific sites (shoulder, sternoclavicular, and hip joints, interspinous bursae, ischial tuberosities, and greater trochanters), we used visual scoring system to score FDG uptake: 0, no uptake (same as bone); 1, slight uptake; 2, moderate uptake (same as the liver); 3, greater uptake than the liver; and 4, uptake as strong as in the cerebellum. Results The final diagnoses were PMR in 17 patients and non-PMR in eight patients (three malignancies, two infections, one cholesterol crystal embolism, one ANCA-associated vasculitis, and one undefined diagnosis). Although the serum MMP-3 levels were significantly higher in patients with PMR, C-reactive protein and erythrocyte sedimentation rate mean values did not differ between the two groups. In PMR-specific sites, FDG accumulations were observed in all cases of PMR, with a high PET-positive score of 2.00 (range, 0–3), but it was low in non-PMR cases, with a PET-positive score of 1.00 (range, 0–3). Conclusions The FDG accumulation patterns in polymyalgia-like illness differ from those in PMR, despite the similar clinical presentations of both conditions. An FDG–PET/CT scan is useful for differentiating PMR from other polymyalgia-like illnesses. |
topic |
Polymyalgia-like illness Polymyalgia rheumatica FDG–PET/CT |
url |
http://link.springer.com/article/10.1186/s41927-020-00121-y |
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