Background/Purpose:

Polymyalgia rheumatica (PMR) is an inflammatory disease characterized by pain and stiffness of the neck, shoulder and pelvic girdles. It can also be accompanied by other non-specific symptoms such as inflammatory low back pain, diffuse lower limb pain and constitutional syndrome. ¹⁸F-FDG PET /CT has been proposed as a promising tool for characterizing the anatomical affection of PMR but it remains unknown if there is a correlation between clinical symptoms and ¹⁸F-FDG uptake.

Objectives:

Our aim was to asses if the localization of pain of patients with PMR correlates with ¹⁸F-FDG uptake in the corresponding region.

Methods:

Study of 75 patients with PMR and their respective PET/CT scans from a referral center. PMR was diagnosed according to 2012 EULAR/ACR criteria. All PET/CT images were evaluated qualitatively by two experienced nuclear medicine physician.

Results:

We evaluated 75 patients (27 men/48 women); mean age±SD of 68.2±0.7 years. A PET/CT was performed in all of them. Pattern of F-FDG uptake in patients with different clinical manifestations are summarized in the TABLE. Twenty-two out of thirty-three patients (66.7%) with ¹⁸F-FDG uptake in sternoclavicular joints had shoulder girdle pain. Twenty-three patients of thirty-two patients (71.8%) with ¹⁸F-FDG uptake in hips had pelvic girdle pain. The remaining localizations of ¹⁸F-FDG uptake in PET/CT scans did not show significant correlations with clinical symptoms.

Conclusion:

In patients with PMR, clinical manifestations do not always correlate with the anatomical location of ¹⁸F-FDG uptake. Only, the presence of shoulder girdle pain seems to correlate with ¹⁸F-FDG uptake in sternoclavicular joints and pelvic girdle pain with ¹⁸F-FDG uptake in hips.