PET-CT findings in patients with polymyalgia rheumatica without symptoms of cranial ischaemia.

INTRODUCTION

Polymyalgia rheumatica (PMR) is an inflammatory disorder that affects the elderly. At present, evidence is limited regarding the usefulness of positron emission tomography-computed tomography (PET-CT) in the diagnosis of PMR. This study aimed to compare patient characteristics and symptoms with PET-CT findings in a Danish population of PMR patients without clinical symptoms of giant cell arteritis.

METHODS

The medical records of 50 Danish PET-CT-scanned patients with PMR were reviewed. Symptoms, characteristics and PET-CT findings were registered from the medical records.

RESULTS

Fluorodeoxyglucose (FDG) uptake was seen at the shoulders and/or hips of about 80%, and at the spinous processes of about 50% of the patients. Furthermore, 14% of the patients showed no FDG uptake at any of the studied locations. A sensitivity of 79% for PMR was found if there was FDG uptake at any two of the following three locations: the shoulder, the hip and the spinous processes. Vascular FDG uptake was seen in 7% of the patients. No significant correlations between any symptoms and any PET-CT findings were found. C-reactive protein level was significantly lower in patients receiving glucocorticoids, and completely normal scans were seen significantly more often in patients receiving steroid treatment.

CONCLUSIONS

PET-CT is a sensitive imaging technique in PMR patients. Symptoms and PET-CT findings do not correlate in PMR. Steroid treatment prior to PET-CT reduces the scan's ability to demonstrate inflammation in PMR patients.

FUNDING: none.

TRIAL REGISTRATION: not relevant.