Characterising polymyalgia rheumatica on whole-body 18F-FDG PET/CT: an atlas

Rheumatol Adv Pract. 2024 Feb 20;8(1):rkae003. doi: 10.1093/rap/rkae003. eCollection 2024.

Abstract

The impact of modern imaging in uncovering the underlying pathology of PMR cannot be understated. Long dismissed as an inflammatory syndrome with links to the large vessel vasculitis giant cell arteritis (GCA), a pathognomonic pattern of musculotendinous inflammation is now attributed to PMR and may be used to confirm its diagnosis. Among the available modalities, 18F-fluorodeoxyglucose (18F-FDG) PET/CT is increasingly recognized for its high sensitivity and specificity, as well as added ability to detect concomitant large vessel GCA and exclude other relevant differentials like infection and malignancy. This atlas provides a contemporary depiction of PMR's pathology and outlines how this knowledge translates into a pattern of findings on whole body 18F-FDG PET/CT that can reliably confirm its diagnosis.

Keywords: diagnosis; imaging; pathology; polymyalgia rheumatica; whole-body positron emission tomography/computed tomography.

Publication types

  • Review