Musculoskeletal ultrasound in the evaluation of Polymyalgia Rheumatica

Iagnocco, Annamaria; Finucci, Annacarla; Ceccarelli, Fulvia; Scirocco, Chiara; Rutigliano, Iolanda Maria

doi:10.11152/mu.2013.2066.173.aig

Cited by 16 publications

(9 citation statements)

References 21 publications

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“…najmniej 4 punktów z 6 analizowanych kryteriów klinicznych pozwala na rozpoznanie choroby z czułością 68% i ze swoistością 78%, natomiast uzyskanie co najmniej 5 punktów z 8-punktowej skali kryteriów ultrasonograficznych umożliwia rozpoznanie PMR z czułością 81% i swoistością 66%. Wydaje się zatem, że badanie USG odgrywa szczególnie ważną rolę w przypadkach wątpliwych (17)(18)(19) (ryc. 2).…”

Section: Discussionunclassified

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Rola ultrasonografii w diagnostyce chorób reumatycznych w świetle wytycznych ACR/EULAR

et al. 2016

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In the past years, ultrasound imaging has become an integral element of the diagnostic process in rheumatic diseases. It enables the identification of a range of inflammatory changes in joint cavities, sheaths and bursae, and allows their activity to be assessed. In 2012, experts of the European Society of Musculoskeletal Radiology prepared recommendations concerning the role of ultrasonography in the diagnosis of musculoskeletal diseases. Ultrasound was considered the method of choice in imaging peripheral synovitis. Moreover, ultrasound imaging has been popularized thanks to the new classification criteria for rheumatoid arthritis issued by the American College of Rheumatology and European League Against Rheumatism in 2010. They underline the role of ultrasound imaging in the detection of articular inflammatory changes that are difficult to assess unambiguously in the clinical examination. These criteria have become the basis for recommendations prepared by experts from the European League Against Rheumatism concerning medical imaging in rheumatoid arthritis. Nine of ten recommendations concern ultrasonography which is relevant in detecting diseases, predicting their progression and treatment response, monitoring disease activity and identifying remission. In the new criteria concerning polymyalgia rheumatica from 2012, an ultrasound scan of the shoulder and pelvic girdle was considered an alternative to clinical assessment. Moreover, the relevance of ultrasonography in the diagnosis and monitoring of peripheral spondyloarthropathies was widely discussed in 2014 during the meeting of the European League Against Rheumatism in Paris.

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Section: Discussionunclassified

“…However, the score of 5 on the 8-score ultrasound scale allows PMR to be detected with the sensitivity of 81% and specificity of 66%. It seems, therefore, that US plays a particularly important role in the event of doubts ( 17 – 19 ) ( Fig. 2 ).…”

Section: Polymyalgia Rheumaticamentioning

confidence: 98%

Rola ultrasonografii w diagnostyce chorób reumatycznych w świetle wytycznych ACR/EULAR

et al. 2016

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“…US can show effusion in the bicipital groove, thickened axillary pouch, and hypervascular hypoechoic tissue at the rotator interval in patients with FS [ 17 , 18 , 19 , 20 , 21 , 22 ]. Both PMR and FS can show similar findings in a shoulder US, suggesting tenosynovitis and glenohumeral synovitis [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ]. However, the typical US findings have not been clearly established in either disease entity.…”

Section: Introductionmentioning

confidence: 89%

Comparison of Shoulder Ultrasonographic Assessments between Polymyalgia Rheumatica and Frozen Shoulder in Patients with Bilateral Shoulder Pain: A Comparative Retrospective Study

Park

Cho

et al. 2021

JPM

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This study aimed to assess and compare the ultrasonographic (US) pathologic findings in patients with polymyalgia rheumatica (PMR) and bilateral frozen shoulder (FS). We included 19 patients with clinically diagnosed PMR and 19 patients with stage II bilateral FS. The US evaluation included the assessment of subacromial-subdeltoid (SASD) bursitis, long head of biceps (LHB) tenosynovitis, and posterior and inferior glenohumeral (GH) synovitis. Unilateral SASD bursitis was noted significantly more frequently in PMR patients than in bilateral FS patients (p = 0.001). There were no significant differences in the incidence of unilateral LHB tenosynovitis and posterior GH synovitis between PMR and bilateral FS patients (p = 0.108 and p = 0.304, respectively). Unilateral inferior GH synovitis was more common among bilateral FS patients than among PMR patients (p < 0.001). Bilateral SASD bursitis and LHB tenosynovitis were noted significantly more frequently in PMR patients than in bilateral FS patients (p < 0.001 and 0.049, respectively). Significant differences were not observed in the incidence of bilateral posterior GH synovitis between PMR and bilateral FS patients (p = 0.426). Bilateral inferior GH synovitis was more common among bilateral FS patients than among PMR patients (p = 0.044). The US evidence for bilateral inferior GH synovitis without bilateral SASD showed high specificity (94.7%) with sensitivity (78.9%) for the diagnosis of bilateral FS. SASD bursitis, representing periarticular synovial inflammation, was more common among the patients with PMR than among the patients with bilateral FS. Inferior GH synovitis without SASD bursitis suggests FS rather than PMR in patients with bilateral shoulder pain.

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“…According to literature data, a typical sonographic PM pattern involves bilateral subacromial/subdeltoid (SAD) bursae with the appearance of bursitis followed by tenosynovitis of the long head of the biceps (LTB). Less frequently, hip synovitis and trochanteric bursitis occur (11). In accordance with the EULAR and ACR provisional classification criteria, suspected cases of PM should have an ultrasound assessment of the shoulder and pelvic girdles (to identify included criteria of subdeltoid bursitis, trochanteric bursitis, LTB tenosynovitis, glenohumeral synovitis, or hip synovitis).…”

Section: Ultrasonographymentioning

confidence: 99%

Imaging in polymyalgia rheumatica: which technique to use?

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Skoczyńska

McConnell

et al. 2021

Clinical and Experimental Rheumatology

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Polymyalgia rheumatica (PM) is an inflammatory rheumatic disorder characterised by pain and stiffness, mainly in the neck, shoulders, and pelvic girdle and possible association with giant cell arteritis. Currently, there is no diagnostic gold standard for PM, however, an extensive assessment of patients' inflammatory status aided by imaging evaluation is crucial for disease stratification. Many imaging techniques study PM features and their possible complications or associations with giant cell arteritis: radiography, ultrasound, scintigraphy, magnetic resonance imaging, and positron emission tomography/computed tomography. Each one has different advantages and disadvantages. The aim of this review is to clarify the current uses of imaging in PM for diagnosis and follow-up through a literature review of the last 10 years.

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Musculoskeletal ultrasound in the evaluation of Polymyalgia Rheumatica

Cited by 16 publications

References 21 publications

Rola ultrasonografii w diagnostyce chorób reumatycznych w świetle wytycznych ACR/EULAR

Rola ultrasonografii w diagnostyce chorób reumatycznych w świetle wytycznych ACR/EULAR

Comparison of Shoulder Ultrasonographic Assessments between Polymyalgia Rheumatica and Frozen Shoulder in Patients with Bilateral Shoulder Pain: A Comparative Retrospective Study

Imaging in polymyalgia rheumatica: which technique to use?

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