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.