Vasculitis & polymyalgia rheumatica
Magnetic resonance imaging of hand involvement in polymyalgia rheumatica: a comparison with seropositive rheumatoid arthritis
Authors' conclusion
Hand involvement in PMR could be clearly differentiated in ceMRI from RA+ by the intensity of periarticular inflammation of MCP joints.
Study context
- Population
- Patients with polymyalgia rheumatica (PMR) and clinically suspected hand involvement and age/sex-matched patients with seropositive rheumatoid arthritis (RA) undergoing contrast-enhanced MRI (ceMRI) of the hand
- Exposure
- PMR with clinically suspected hand involvement vs seropositive RA
- Outcome
- Inflammatory pattern on ceMRI of hand involvement (synovitis, osteitis, erosions of metacarpophalangeal (MCP) joints 2-5, flexor/extensor tenosynovitis, periarticular inflammation around MCP joints)
Methodological detailsmatched for age/sex, contrast-enhanced MRI, RAMRIS scoring, semi-quantitative periarticular inflammation score
- Matched for age/sex
- Contrast-enhanced MRI
- RAMRIS scoring
- Semi-quantitative periarticular inflammation score
Main finding
As reported in the abstract
ceMRI inflammatory pattern, PMR vs RA+
- Distribution of synovitis scores differed significantly: mostly minor and occasionally moderate synovitis in PMR vs uniformly distributed total scores in RA+
- p<0.001
- Periarticular inflammation scores significantly higher in PMR
- p<0.001
- Extensor and flexor tenosynovitis prevalent in both groups; flexor tenosynovitis significantly more prevalent in PMR
- p<0.001
- Erosions and osteitis absent in PMR but prevalent in RA+
- p<0.001
Observational data: associations, not effects.
Further findings
Diagnostic performance of minor to moderate synovitis plus severe periarticular inflammation of an MCP joint for differentiating PMR from RA+
Sensitivity
Specificity
Original publication
Magnetic resonance imaging of hand involvement in polymyalgia rheumatica: a comparison with seropositive rheumatoid arthritis. RMD Open. Published 7 May 2026. doi:10.
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