Sonographic and electrodiagnostic evaluations in patients with aromatase inhibitor-related arthralgia.
OBJECTIVE
To investigate the prevalence of arthralgia in breast cancer patients taking aromatase inhibitors (AIs) and perform a detailed rheumatologic assessment including autoimmune serology, musculoskeletal sonography, and electromyography (EMG) in these patients.


METHODS
Postmenopausal patients with stage I to III breast cancer who were taking adjuvant AIs were enrolled (n = 92). Patients who were not receiving hormone treatment were included as a control group (n = 28). Musculoskeletal sonography and EMG were applied to the patients and the controls along with markers of autoimmunity.


RESULTS
Thirty patients (32.6%) reported to have AI-related new-onset or worsening arthralgia. The most commonly affected joints were knee (70%), wrist (70%), and small joints of the hand (63%). Patients taking AIs had increased tendon thicknesses compared with those who never received AIs (P < .001). Patients with AI-related arthralgia had higher rates of effusion in hand joints/tendons than those without arthralgia (P = .033). More patients with AI-related arthralgia had EMG findings consistent with carpal tunnel syndrome (CTS) than those without arthralgia (P = .024). No significant difference was observed in erythrocyte sedimentation rates, C-reactive protein, antinuclear antibody, antidouble stranded DNA antibody, rheumatoid factor, or anticyclic citrullinated peptide levels between patients and controls or between those with and without arthralgia.


CONCLUSIONS
Patients with AI-related arthralgia often show tenosynovial changes suggesting tenosynovitis, exerting local problems but lacking a systemic inflammatory component. Our finding of increased CTS frequency also supports this hypothesis.
Dizdar
Omer
O
Hacettepe University Institute of Oncology, Department of Medical Oncology, Ankara, Turkey. omerdiz@yahoo.com
Ozçakar
Levent
L
Malas
Fevziye Unsal
FU
Harputluoglu
Hakan
H
Bulut
Nilufer
N
Aksoy
Sercan
S
Ozisik
Yavuz
Y
Altundag
Kadri
K
D000328:Adult; D000368:Aged; D047072:Aromatase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D018771:Arthralgia / Q000139:chemically induced* / Q000175:diagnosis* / Q000453:epidemiology; D001943:Breast Neoplasms / Q000188:drug therapy*; D004576:Electromyography; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D015995:Prevalence; D011446:Prospective Studies; D014463:Ultrasonography
D047072:Aromatase Inhibitors