Polymyalgia rheumatica and rheumatoid arthritis of the elderly: a clinical, laboratory, and scintigraphic comparison.

Häntzschel, H; Bird, H. A.; Seidel, W.; Krüger, Wanda M. A. von; Neumann, G; Schneider, Günther; Wright, V.

doi:10.1136/ard.50.9.619

Cited by 25 publications

(11 citation statements)

References 5 publications

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“…With regard to laboratory variables a significant prevalence of RF and anti-CCP Abs in EORA supported the usefulness of these tests in differential diagnosis, as reported previously (28,29). Erosions were significantly prevalent in EORA, but they were never evident at onset and they cannot be used to predict definitive diagnosis.…”

Section: Discussionsupporting

confidence: 77%

Ultrasonography in early assessment of elderly patients with polymyalgic symptoms: a role in predicting diagnostic outcome?

Falsetti

Acciai

Volpe

et al. 2010

Scandinavian Journal of Rheumatology

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Section: Discussionsupporting

confidence: 77%

Ultrasonography in early assessment of elderly patients with polymyalgic symptoms: a role in predicting diagnostic outcome?

Falsetti

Acciai

Volpe

et al. 2010

Scandinavian Journal of Rheumatology

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“…Some cases of EORA have a PMR-like appearance, characterized by shoulder/pelvic involvement, an absence of RF, and a nonerosive course. 13,[28][29][30] Anti-CCP Ab may be useful in the differential diagnosis because of the excellent specifi city to RA. 31,32 In this study, all patients were negative for anti-CCP Abs ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…The presence of proximal articular and periarticular synovitis in PMR has been proven by arthroscopy, 8 synovial biopsy, 9,10 ultrasonography (US), 11,12 scintigraphy, 13 and magnetic resonance imaging (MRI). 14 Using US and MRI of the shoulders, Cantini et al showed that subacromial and subdeltoid (SA-SD) bursal synovitis (= bursitis) is the most frequent and unique lesion present in almost all PMR patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical characteristics of polymyalgia rheumatica in Japanese patients: evidence of synovitis and extracapsular inflammatory changes by fat suppression magnetic resonance imaging

2007

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Polymyalgia rheumatica (PMR) is an inflammatory condition of unknown etiology characterized by diffuse pain and morning stiffness involving neck, shoulder, and pelvic girdles. To facilitate an understanding of PMR and its proper diagnosis, we evaluated clinical symptoms, laboratory data, and radiographic findings of 32 Japanese patients with it. Distal musculoskeletal manifestations were more frequently observed than had been thought before (81% of the patients), and peripheral arthritis was most common (75%). The joints most often affected were knees and wrists, and most episodes were presented as bilateral oligo- or polyarthritis. A swelling of hands was observed in 34% of the patients. Using contrast-enhanced fat suppression magnetic resonance imaging (MRI) of the shoulder, we found the evidence of subacromial and subdeltoid bursitis (100%), glenohumeral joint synovitis (93%), and biceps tenosynovitis (57%) in the PMR patients examined. Inflammatory changes in soft tissues around the joint capsule were prominent. By knee MRI, suprapatellar bursitis and joint synovitis were visualized in all cases examined, and extracapsular abnormalities were also prominent in 90% of the patients. Serum matrix metalloproteinase-3, a parameter of synovial inflammation, was significantly increased in PMR patients. Anticyclic citrullinated peptide antibody was useful for differential diagnosis between PMR and elderly onset rheumatoid arthritis. In conclusion, joint and periarticular synovitis seems to be commonly and primarily responsible for the proximal and distal musculoskeletal symptoms of PMR. The presence of the extracapsular change, probably a nonspecific extension of synovitis, can explain the severe discomfort that radiates toward the periphery. To avoid making a wrong diagnosis, we should be aware that peripheral synovitis is one of the hallmarks of PMR.

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“…These include scintigraphic evaluation of the shoulder,8 thrombocytosis,31 serum cytidine deaminase,11 and antibodies to laminin B2 protein 32. However, all these observations need further confirmation and none of them is usually used in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Presenting features of polymyalgia rheumatica (PMR) and rheumatoid arthritis with PMR-like onset: a prospective study

Caporali

2001

Annals of the Rheumatic Diseases

127

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Objective-To evaluate in a prospective study whether patients with polymyalgia rheumatica (PMR) and patients with rheumatoid arthritis (RA) with PMR-like onset show distinctive clinical and laboratory features. Methods-A cohort of 116 consecutive patients with bilateral girdle pain for at least one month and raised erythrocyte sedimentation rate (ESR) was studied and followed up for 12 months. Laboratory tests included determination of ESR, IgM rheumatoid factor, haemoglobin, white blood cell count, platelet count, percentage of CD8 lymphocytes, serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and glutamyltransferase concentrations.

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Polymyalgia rheumatica and rheumatoid arthritis of the elderly: a clinical, laboratory, and scintigraphic comparison.

Cited by 25 publications

References 5 publications

Ultrasonography in early assessment of elderly patients with polymyalgic symptoms: a role in predicting diagnostic outcome?

Ultrasonography in early assessment of elderly patients with polymyalgic symptoms: a role in predicting diagnostic outcome?

Clinical characteristics of polymyalgia rheumatica in Japanese patients: evidence of synovitis and extracapsular inflammatory changes by fat suppression magnetic resonance imaging

Presenting features of polymyalgia rheumatica (PMR) and rheumatoid arthritis with PMR-like onset: a prospective study

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