Joint involvement in patients with early polymyalgia rheumatica using high-resolution ultrasound and its contribution to the EULAR/ACR 2012 classification criteria for polymyalgia rheumatica

J Rheumatol. 2014 Apr;41(4):730-4. doi: 10.3899/jrheum.130946. Epub 2014 Mar 1.

Abstract

Objective: To assess joint involvement and the contribution of musculoskeletal ultrasound (MSUS) to the novel European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) 2012 classification criteria in patients with polymyalgia rheumatic (PMR).

Methods: MSUS was performed in 54 consecutive patients with recent-onset PMR.

Results: Biceps tenosynovitis of at least 1 shoulder has been observed in 70.4% of patients, and 64.8% had a bilateral biceps tenosynovitis. Subdeltoid bursitis (27.8% unilateral, 5.6% bilateral), glenohumeral synovitis (22.2% unilateral, 9.3% bilateral), and hip involvement (22.2% unilateral, 16.7% bilateral) were observed less frequently. The sensitivities of the classification criteria were 85.2% for EULAR/ACR without MSUS and 81.5% for EULAR/ACR with MSUS.

Conclusion: The most common MSUS pathology was a biceps tenosynovitis. However, US findings had no effect on the sensitivity of the novel EULAR/ACR criteria for PMR.

Keywords: CLASSIFICATION CRITERIA; POLYMYALGIA RHEUMATICA; ULTRASONOGRAPHY; VASCULITIS.

MeSH terms

  • Age Factors
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Joint Diseases / complications
  • Joint Diseases / diagnostic imaging*
  • Joint Diseases / physiopathology
  • Male
  • Middle Aged
  • Polymyalgia Rheumatica / classification*
  • Polymyalgia Rheumatica / complications
  • Polymyalgia Rheumatica / diagnostic imaging*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Sex Factors
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / physiopathology
  • Societies, Medical / standards
  • Synovitis / diagnostic imaging
  • Synovitis / physiopathology
  • Tenosynovitis / diagnostic imaging
  • Tenosynovitis / physiopathology
  • Ultrasonography, Doppler / methods*