ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1983

Interspinous Bursitis Evaluation By Ultrasound Is Very Useful for Diagnosis of Polymyalgia Rheumatica

Kensuke Kume1, Kanzo Amano2, Susumu Yamada1, Toshikatsu Kanazawa3, Hiroshi Komori1, Kazuhiko Hatta4 and Noriko Kuwaba5, 1Rheumatology, Hiroshima Clinic, Hiroshima, Japan, 2rheumatology., hiroshima clinic, Hiroshima, Japan, 3rheumatology, hiroshima clinic, hiroshima, Japan, 4Rheumatology, Hatta Clinic, Kure, Japan, 5Medical Research, Sanki Clinical Link, Hiroshima, Japan

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ,

Session Information

Date: Monday, November 9, 2015

Title: Vasculitis Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Polymyalgia rheumatica (PMR) is a common inflammatory disease of the elderly, and 2012 provisional classification criteria were suggested, however it is provisional and not meant for diagnosis purpose1). Ultrasound(US), MRI and other modalities were often detected interspinous bursitis in patients with PMR2). To develop 2012 provisional classification criteria, adding interspinous bursitis evaluation by US.

Methods: This is a prospective cohort study. Candidate criteria were evaluated 117 patients with new onset untreated PMR, and 128 patiens non-PMR comparison subjects with conditions mimicking PMR. We compared the sensitivity and specificity of 2012 provisional classification criteria with 2012 provisional classification criteria, adding interspinous bursitis evaluation by US. US evaluation was checked cervical and lumbar spine, and if at least one interspinous bursitis was detected, it was calculated 1 point. Total score(interspinous bursitis evaluation by US score plus 2012 provisional classification criteria with US score) was 5 or more, it is categorised as PMR.

Results: 2012 provisional classification criteria scoring system had 68% sensitivity and 79% specificity. Adding interspinous bursitis by US had significantly increased sensitivity to 86 %( p<0.05), and not significantly decreased specificity to 76 %( p=0.47) Surprisingly, PMR patients without cervical or lumbar pain had interspinous bursitis with high prevalence. (74%) No correlation was found between interspinous bursitis by US and spontaneous or provoked pain. (r =0.12, P =0.45)

Conclusion: Interspinous bursitis by US is very sensitive in patients with PMR. Interspinous bursitis by US should be added classification criteria for PMR. If patients were suspected of PMR, interspinous bursitis by US should be performed with or without cervical or lumbar pain.

References)

1)Dasgupta B, et al. 2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative.Ann Rheum Dis. 2012 Apr;71(4):484-92. doi: 10.1136/annrheumdis-2011-200329.

2)Camellino D, et al. Interspinous bursitis is common in polymyalgia rheumatica, but is not associated with spinal pain.Arthritis Res Ther. 2014 Dec 1;16(6):492. [Epub ahead of print]

Disclosure: K. Kume, None; K. Amano, None; S. Yamada, None; T. Kanazawa, None; H. Komori, None; K. Hatta, None; N. Kuwaba, None.

To cite this abstract in AMA style:

Kume K, Amano K, Yamada S, Kanazawa T, Komori H, Hatta K, Kuwaba N. Interspinous Bursitis Evaluation By Ultrasound Is Very Useful for Diagnosis of Polymyalgia Rheumatica [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/interspinous-bursitis-evaluation-by-ultrasound-is-very-useful-for-diagnosis-of-polymyalgia-rheumatica/. Accessed .

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