New arguments for a vasculitic nature of polymyalgia rheumatica using positron emission tomography.
OBJECTIVE
To study the possible contribution of fluorodeoxyglucose (FDG)-positron emission tomography (PET) in the diagnosis of giant cell arteritis and polymyalgia rheumatica.


METHODS
A consecutive case series consisting of five patients with polymyalgia rheumatica, six patients with temporal arteritis and 23 age-matched patients with other inflammatory conditions were evaluated with FDG-PET. Studies were performed before therapy with steroids was started.


RESULTS
A total of 4/6 patients with giant cell arteritis and 4/5 patients with polymyalgia had increased FDG uptake in their thoracic vessels, compared to 1/23 controls (P < 0.001). Increased vascular FDG uptake in the upper legs was seen in 8/11 patients with giant cell arteritis or polymyalgia compared to 8/23 control patients (P < 0.05), and in the lower legs in 6/11 patients compared to 6/23 controls (P = not significant).


CONCLUSIONS
FDG-PET scan is the first non-invasive technique which may indicate large-vessel vasculitis and which can show its extension throughout the body. It strongly suggests that polymyalgia rheumatica is a form of vasculitis.
Blockmans
D
D
Department of General Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
Maes
A
A
Stroobants
S
S
Nuyts
J
J
Bormans
G
G
Knockaert
D
D
Bobbaers
H
H
Mortelmans
L
L
D000368:Aged; D001013:Aorta, Thoracic; D005260:Female; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D013348:Subclavian Artery; D014055:Tomography, Emission-Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18