Vasculitis & polymyalgia rheumatica
Vascular MRI also depicts musculoskeletal manifestations in giant-cell arteritis–polymyalgia rheumatica spectrum disease patients
Authors' conclusion
Fifty-one percent of the GPSD patients showed signs of inflammation in at least one of the evaluated musculoskeletal structures on contrast-enhanced MRI, with the subscapularis tendon being the most frequently affected.
Study context
- Population
- Patients with clinically confirmed GCA and PMR (GCA-PMR) spectrum disease (GCA-PMR spectrum disease (GPSD)) with contrast-enhanced T1-weighted VIBE MRI of the torso acquired for aortic vessel wall imaging
- Participants
- 78 patients
- Exposure
- GCA vs PMR vs GCA-PMR
- Outcome
- Signs of inflammation in glenohumeral synovium, long biceps and subscapularis tendons, supra-/interspinous ligaments, and shoulder joint effusion on contrast-enhanced vascular MRI
Methodological detailsindependent reading by two experienced radiologists and two inexperienced readers, inter-rater reliability (Fleiss's kappa)
- Independent reading by two experienced radiologists and two inexperienced readers
- Inter-rater reliability (Fleiss's kappa)
Main finding
As reported in the abstract
Musculoskeletal inflammation on contrast-enhanced MRI, all patients
- Glenohumeral synovitis
- 35%
- Shoulder joint effusion
- 6%
- Long biceps tendon enhancement
- 26%
- Subscapularis tendon enhancement
- 42%
- Supra-/interspinous ligament enhancement
- 29%
Observational data: associations, not effects.
Further findings
Diagnostic distribution
Inflammatory signs by diagnosis
- Patients with PMR showed inflammatory signs at a higher percentage than those with GCA or GCA-PMR
Inter-rater agreement (Fleiss's kappa)
- Almost perfect agreement among readers for supra-/interspinous ligament and subscapularis tendon assessments
Original publication
Vascular MRI also depicts musculoskeletal manifestations in giant-cell arteritis–polymyalgia rheumatica spectrum disease patients. Rheumatology (Oxford). Published 25 March 2025. doi:10.
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