title: Interspinous bursitis is common in polymyalgia rheumatica, but is not associated with spinal pain.
abstract: BACKGROUND
  Polymyalgia rheumatica (PMR) is a common inflammatory disease in older people characterized by shoulder and/or pelvic girdle, and cervical and, occasionally, lumbar pain. Interspinous bursitis has been suggested as a potential cause of spinal symptoms. We evaluated, by 18 F-fluorodeoxyglucose (FDG) positron emission tomography integrated with computed tomography (PET/CT), the vertebral structures involved in PMR in a cohort of consecutive, untreated patients.
  
  
  METHODS
  Sixty-five consecutive patients with PMR were studied. After a standardized physical examination, which included evaluation of pain and tenderness in the vertebral column, they underwent FDG-PET/CT. Sites of increased uptake and their correlation with spontaneous and provoked pain were recorded. For comparison, FDG-PET/CT was performed also in 65 age- and sex-matched controls and in 10 rheumatoid arthritis (RA) patients.
  
  
  RESULTS
  The most frequent site of spontaneous and provoked pain was the cervical portion. FDG uptake was more frequent in the lumbar portion than at any other location, and in the cervical rather than in the thoracic portion (P <0.0001). No correlation was found between uptake and spontaneous or provoked pain. There was an association between presence of cervical and lumbar bursitis (r = 0.34, P = 0.007). None of the control patients and one out of ten RA patients showed interspinous bursitis.
  
  
  CONCLUSIONS
  Interspinous bursitis is a frequent finding in the lumbar spine of patients with PMR. However, it is not associated with clinical symptoms and can hardly explain the spinal pain reported by the patients. Cervical pain is more frequent than lumbar pain in PMR patients and may be caused by shoulder girdle involvement.
authors.forename: Dario
authors.initials: D
authors.lastname: Camellino
authors.forename: Francesco
authors.initials: F
authors.lastname: Paparo
authors.forename: Silvia
authors.initials: S
authors.lastname: Morbelli
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cutolo
authors.forename: Gianmario
authors.initials: G
authors.lastname: Sambuceti
authors.forename: Marco A
authors.initials: MA
authors.lastname: Cimmino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000150:complications / Q000175:diagnosis*; D002574:Cervical Vertebrae / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000150:complications / Q000175:diagnosis*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000150:complications / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods