Polymyalgia rheumatica is associated with extensor tendon tenosynovitis but not with synovitis of the hands: a magnetic resonance imaging study.
OBJECTIVE
To study with MRI the hands of consecutive PMR patients, who were not selected on the basis of peripheral arthritis, with a correlation to clinical and laboratory findings.


METHODS
Twenty-six hands of 15 PMR patients and 26 hands of 13 healthy controls were studied by extremity-dedicated MRI for the presence of synovitis, tenosynovitis, soft-tissue oedema, bone marrow oedema and erosions.


RESULTS
Sixteen (61.6%) of the 26 PMR hands and 4 (15.4%) of the 26 control hands showed tenosynovitis (P = 0.001). Extensor tendon tenosynovitis was seen in 9 (34.6%) of the 26 PMR hands, but in only 1 (3.8%) control hand (P = 0.002) and flexor tenosynovitis was seen in 12 (46.1%) of the 26 PMR hands and in 4 (15.4%) of the 26 control hands (P = 0.03). All other features were similar in the two groups.


CONCLUSIONS
Our data support the view that tenosynovitis, especially of the extensor tendons, is a frequent event in PMR, unrelated to clinical involvement of the hand. This finding is in agreement with the concept of PMR as a disease of extra-articular structures.
Dipartimento di Medicina Interna e Specialità Mediche, Clinica Reumatologica, Viale Benedetto XV 6, 16132 Genova, Italy. cimmino@unige.it
Marco A
MA
Cimmino
Massimiliano
M
Parodi
Giuseppe
G
Zampogna
Francesca
F
Barbieri
Giacomo
G
Garlaschi
D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006225:Hand; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000175:diagnosis*; D013585:Synovitis / Q000175:diagnosis*; D013717:Tenosynovitis / Q000175:diagnosis*