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See Latest ArticlesLongitudinal examination with shoulder ultrasound of patients with polymyalgia rheumatica
Rheumatology, 10/08/09
Macchioni PL et al. – Subclinical inflammation detected by US persists in most PMR patients despite glucocorticoid treatment. PDUS may be useful to detect at diagnosis the patients with most active inflammation who have a higher risk of relapses/recurrences.
Methods- Mean of 41 mos, 57 consecutive untreated patients with PMR prospectively assessed for relapses/recurrences
- Cohort represented all patients diagnosed over 18-month period in one Italian secondary referral centre
- Clinical signs and symptoms, ESR and CRP evaluated
- US examination of shoulders performed in all 57 patients at diagnosis and after onset of prednisone treatment
- Power Doppler ultrasonography (PDUS) performed in 24 patients
- Shoulder sonograms obtained according to standardized techniques
- Prednisone therapy significantly reduced frequency and degree of subacromial/subdeltoid bursitis, long head biceps tenosynovitis and glenohumeral synovitis
- At diagnosis, positive PD signal observed more frequently in subacromial/subdeltoid bursae (33%)
- Prednisone therapy significantly reduced frequency of patients with positive PD signal
- Of 44 patients in remission or with low disease activity at time of the second US, 26 (59%) still had evidence of persistent inflammatory lesions
- No association between persistence of inflammation at US and relapses/recurrences; in contrast, positive PD signal at diagnosis significantly associated with occurrence of relapses/recurrences at follow-up
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