Imaging studies in patients with PMR

Bhaskar Dasgupta

Is it necessary to perform imaging studies looking for vasculitides, such as aortitis, in all patients with polymyalgia rheumatica (PMR)? What imaging studies are recommended?

Bhaskar Dasgupta: We do ultrasound and we look at the intimal-medial thickness in the axillary arteries. We do a positron emission tomography (PET) scan, 18F-fluorodeoxyglucose PET computed tomography (18FDG-PET/CT), which will show the inflammation in the aorta, also mainly in the axillary arteries. Upper limb arteries are involved in large-vessel giant cell arteritis (GCA). [These patients] can also have involvement of the carotids, and the vertebral arteries can be involved. So yes, these are the patients we definitely should be imaging with ultrasound and with 18FDG-PET/CT.

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