title: Various forms of (18)F-FDG PET and PET/CT findings in patients with polymyalgia rheumatica.
abstract: OBJECTIVE
  Polymyalgia rheumatica (PMR) is a disease presenting with pain and stiffness, mainly in shoulders, hip joints and neck. Laboratory markers of inflammation may bolster diagnosis. PMR afflicts patients over 50 years old, predominantly women, and may also accompany giant cell arteritis.
  
  
  METHODS
  67 patients, who fullfiled Healey´s criteria for PMR in the period between 2004 and 2013 and had positive FDG PET (PET/CT) findings were retrospectively evaluated. FDG uptake was assessed in large arteries, proximal joints (shoulders, hips and sternoclavicular joints), in extraarticular synovial structures (interspinous, ischiogluteal and praepubic bursae).
  
  
  RESULTS
  Articular/periarticular involvement (A) was detected in 59/67 (88.1%) patients and extrarticular synovial involvement (E) in 51/67 (76.1%) patients either individually or in combinations. Vascular involvement (V) was detected in 27/67 (40.3%) patients only in combination with articular (A) and/or extraarticular synovial (E) involvement. These combinations were: A+E involvement in 30/67 (44.8%) patients, A+V involvement in 8/67 (11.9%) patients, E+V involvement in 6/67 (9%) patients and A+E+V in 13/67 (19.4%) patients.
  
  
  CONCLUSIONS
  PMR presents by articular/periarticular synovitis, extraarticular synovitis and can be accompanied by giant cell arteritis. All types of involvement have their distinct FDG PET (PET/CT) finding, which can be seen either individually or in any of their 4 combinations. FDG PET (PET/CT) examination seems to be an advantageous one-step examination for detecting different variants of PMR, for assessing extent and severity and also for excluding occult malignancy.
authors.affiliation: Department of Nuclear Medicine and PET Center, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic.|Regional Center of Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute Brno.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Rehak
authors.affiliation: Department of Nuclear Medicine and PET Center, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic.|Center of Molecular Imaging, International Clinical Research Center (ICRC), St. Anne's University Hospital in Brno.
authors.forename: Jiri
authors.initials: J
authors.lastname: Vasina
authors.affiliation: Rheumatology Unit, 2nd Department of Internal Medicine, St. Anne´s University Hospital Brno and Faculty of Medicine, Masaryk University, Brno.
authors.forename: Petr
authors.initials: P
authors.lastname: Nemec
authors.affiliation: Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Fojtik
authors.affiliation: Department of Nuclear Medicine and PET Center, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Renata
authors.initials: R
authors.lastname: Koukalova
authors.affiliation: Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno.
authors.forename: Zbynek
authors.initials: Z
authors.lastname: Bortlicek
authors.affiliation: Department of Internal Medicine, Geriatrics and Practical Medicine, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno.
authors.forename: Dorota
authors.initials: D
authors.lastname: Rehakova
authors.affiliation: Regional Center of Applied Molecular Oncology (RECAMO), Masaryk Memorial Cancer Institute Brno.|Radiopharmaceuticals Division, UJV Rez, a. s., Rez.
authors.forename: Jan
authors.initials: J
authors.lastname: Adam
authors.affiliation: Department of Internal Medicine, Hospital Trebic Corresponding author: Zdenek Rehak, e-mail:
authors.forename: Alena
authors.initials: A
authors.lastname: Vavrusova
authors.affiliation: Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno.
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Adam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002062:Bursitis / Q000000981:diagnostic imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D011111:Polymyalgia Rheumatica / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013585:Synovitis / Q000000981:diagnostic imaging; D014657:Vasculitis / Q000000981:diagnostic imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: FDG; PET; PET/CT; bursitis; giant cell arteritis; polymyalgia rheumatica; synovitis; vasculitis