Vasculitis & polymyalgia rheumatica
Musculoskeletal magnetic resonance imaging findings support a common spectrum of giant cell arteritis and polymyalgia rheumatica
Authors' conclusion
MRI shows CE of musculoskeletal structures typical of PMR in most patients with GCA, supporting the concept of 'GCA-PMR spectrum disease'. Changes are more frequent at periarticular/musculotendinous sites and in the presence of PMR symptoms. A clear response to GCs is evident, less so for periarticular/musculotendinous sites.
Study context
- Population
- Consecutive patients with giant cell arteritis (GCA) undergoing MRI of the thorax/abdomen/pelvis
- Exposure
- Patients with vs without GC treatment at time of MRI; with vs without polymyalgia rheumatica (PMR) symptoms
- With GCsn = 45
- With PMR symptomsn = 54
- Without PMR symptomsn = 36
- Outcome
- Proportion and distribution of CE of musculoskeletal structures on MRI of the thorax/abdomen/pelvis
Methodological detailsconsecutive patients, four-point ordinal scale at 34 musculoskeletal sites, two composite MRI scores
- Consecutive patients
- Four-point ordinal scale at 34 musculoskeletal sites
- Two composite MRI scores
Main finding
As reported in the abstract
Contrast enhancement (CE) in lumbar spines
90.7%
CE in pelvis
87.5%
CE in shoulder girdles
82.2%
CE at any site
95.6%
Observational data: associations, not effects.
Further findings
| Outcome | Without GCs | With GCs | Mean difference |
|---|---|---|---|
| At least moderate enhancement at ≥1-3 sites | 91.1% | 75.6% | |
| At least moderate enhancement at ≥4-6 sites | 75.6% | 51.1% | |
| At least moderate enhancement at ≥7-9 sites | 64.4% | 28.9% | |
| Proportion of pathological CE, with vs without GCsSynovial sites | 27.4% | ||
| Proportion of pathological CE, with vs without GCsPeriarticular/musculotendinous sites | 18.3% |
Composite MRI scores
- Both composite scores captured substantial differences between groups; correlation very strong between scores
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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