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Aktuelle Rheumatologie 2014; 39(04): 232-237
DOI: 10.1055/s-0034-1372603
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© Georg Thieme Verlag KG Stuttgart · New York

Bildgebung bei Polymyalgia rheumatica

Imaging Diagnostics in Polymyalgia Rheumatica
W. A. Schmidt
1   Innere Medizin, Rheumatologie und Klinische Immunologie, Immanuel-Krankenhaus Rheumaklinik Berlin-Buch, Berlin
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Publication History

Publication Date:
15 August 2014 (online)

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Zusammenfassung

Bei der Polymyalgia rheumatica lassen sich bildgebend typische entzündliche Befunde in der Schulter- und Hüftregion sowie paravertebral nachweisen. Positronenemissionstomografie und Magnetresonanztomografie geben eine gute Übersicht, sind aber aus Kostengründen der Sonografie der Schulter- und Hüftregionen unterlegen. Neue Klassifikationskriterien weisen unter Einschluss der Sonografie eine deutlich höhere Spezifität auf. Bildgebend sollte in der Regel mittels Sonografie der Temporal- und Axillararterien, ggf. auch durch andere bildgebende Verfahren, eine begleitende Riesenzellarteriitis ausgeschlossen oder nachgewiesen werden.

Abstract

In polymyalgia rheumatica imaging techniques show inflammation in shoulders and hips as well as in paravertebral regions. Positron emission tomography and magnetic resonance imaging provide a good overview. However, in clinical practice ultrasound is more commonly used because of availability and cost issues. New classification criteria are more specific when including an algorithm with ultrasound. In addition, ultrasound of temporal and axillary arteries, if necessary with other imaging modalities, should be performed for diagnosing or excluding con­comitant giant cell arteritis.

Schlüsselwörter

Polymyalgia rheumatica - Riesenzellarteriitis - Sonografie - Magnetresonanztomografie - Positronenemissionstomografie

Key words

polymyalgia rheumatic - giant cell arteritis - ultrasound - magnetic resonance imaging - positron emission tomography
 

  • Literatur

  • 1 Camellino D, Cimmino MA. Imaging of polymyalgia rheumatica: indications on its pathogenesis, diagnosis and prognosis. Rheumatology 2012; 51: 77-86
    CrossrefPubMedGoogle Scholar
  • 2 Blockmans D, De Ceuninck L, Vanderschueren S et al. Repetitive 18-fluorodeoxyglucose positron emission tomography in isolated polymyalgia rheumatica: a prospective study in 35 patients. Rheumatology 2007; 46: 672-677
    CrossrefPubMedGoogle Scholar
  • 3 Schmidt WA, Blockmans D. Use of ultrasonography and positron emission tomography in the diagnosis and assessment of large-vessel vasculitis. Curr Opin Rheumatol 2005; 17: 9-15
    CrossrefPubMedGoogle Scholar
  • 4 Blockmans D, Bley T, Schmidt W. Imaging for large-vessel vasculitis. Curr Opin Rheumatol 2009; 21: 19-28
    CrossrefPubMedGoogle Scholar
  • 5 Bley TA, Ostendorf B, Scherer A et al. MR-Angiographie in der Rheumatologie. Z Rheumatol 2012; 71: 430-435
    CrossrefPubMedGoogle Scholar
  • 6 Bruyn GA, Schmidt WA. Introductory guide to musculoskeletal ultrasound for the rheumatologist. Houten, NL: Bohn Stafleu van Loghum; 2011
    Google Scholar
  • 7 Salvarani C, Cantini F, Olivieri I et al. Proximal bursitis in active polymyalgia rheumatica. Ann Intern Med 1997; 127: 27-31
    CrossrefPubMedGoogle Scholar
  • 8 Cantini F, Salvarani C, Olivieri I et al. Shoulder ultrasonography in the diagnosis of polymyalgia rheumatica: a case-control study. J Rheumatol 2001; 28: 1049-1055
    PubMedGoogle Scholar
  • 9 Dasgupta B, Cimmino MA, Maradit-Kremers H et al. 2012 provisional classification criteria for polymyalgia rheumatica: A European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 2012; 71: 484-492
    CrossrefPubMedGoogle Scholar
  • 10 Schmidt WA, Schicke B, Krause A. Which ultrasound scan is the best to detect glenohumeral joint effusions?. Ultraschall Med 2008; 29 (Suppl. 01) 250-255
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Macchioni P, Catanoso MG, Pipitone N et al. Longitudinal examination with shoulder ultrasound of patients with polymyalgia rheumatica. Rheumatology 2009; 48: 1566-1569
    CrossrefPubMedGoogle Scholar
  • 12 Jiménez-Palop M, Naredo E, Humbrado L et al. Ultrasonographic monitoring of response to therapy in polymyalgia rheumatica. Ann Rheum Dis 2010; 69: 879-882
    CrossrefPubMedGoogle Scholar
  • 13 Matteson EL, Maradit-Kremers H, Cimmino MA et al. Patient-reported outcomes in polymyalgia rheumatica. J Rheumatol 2012; 39: 795-803
    CrossrefPubMedGoogle Scholar
  • 14 Schmidt WA, Schmidt H, Schicke B et al. Standard reference values for musculoskeletal ultrasonography. Ann Rheum Dis 2004; 63: 988-994
    CrossrefPubMedGoogle Scholar
  • 15 Cantini F, Niccoli L, Nannini C et al. Inflammatory changes of hip synovial structures in polymyalgia rheumatica. Clin Exp Rheumatol 2005; 23: 462-468
    PubMedGoogle Scholar
  • 16 Salvarani C, Barozzi L, Cantini F et al. Cervical interspinous bursitis in active polymyalgia rheumatica. Ann Rheum Dis 2008; 67: 758-761
    CrossrefPubMedGoogle Scholar
  • 17 Pease CT, Haugeberg G, Montague B et al. Polymyalgia rheumatica can be distinguished from late onset rheumatoid arthritis at baseline: results of a 5-yr prospective study. Rheumatology 2009; 48: 123-127
    CrossrefPubMedGoogle Scholar
  • 18 Schmidt WA, Gromnica-Ihle E. Polymyalgia rheumatica und Riesenzellarteriitis (Arteriitis temporalis). In: Busse O, Fleig WE, Mayet WJ, Mertens PR, Meyer J, Müller OA, Pfeifer M, Pletz MW, Weiss N. Hrsg Rationelle Diagnostik und Therapie in der Inneren Medizin: Leitlinien-basierte Empfehlungen für die Praxis. München: Elsevier Deutschland; 2011
    Google Scholar
  • 19 Schmidt WA, Gromnica-Ihle E. Incidence of temporal arteritis in pa­tients with polymyalgia rheumatica: a prospective study using colour Doppler sonography of the temporal arteries. Rheumatology 2002; 41: 46-52
    CrossrefPubMedGoogle Scholar
  • 20 Schmidt WA, Seifert A, Gromnica-Ihle E et al. Ultrasound of proximal upper extremity arteries to increase the diagnostic yield in large-vessel giant cell arteritis. Rheumatology 2008; 47: 96-101
    CrossrefPubMedGoogle Scholar
  • 21 Koenigkam-Santos M, Sharma P, Kalb B et al. Magnetic resonance angiography in extracranial giant cell arteritis. J Clin Rheumatol 2011; 17: 306-310
    CrossrefPubMedGoogle Scholar
  • 22 Prieto-González S, Arguis P, García-Martínez A et al. Large vessel involvement in biopsy-proven giant cell arteritis: prospective study in 40 newly diagnosed patients using CT angiography. Ann Rheum Dis 2012; 71: 1170-1176
    CrossrefPubMedGoogle Scholar
  • 23 Schmidt WA, Kraft HE, Vorpahl K et al. Color duplex ultrasonography in the diagnosis of temporal arteritis. N Engl J Med 1997; 337: 1336-1342
    CrossrefPubMedGoogle Scholar
  • 24 Bley TA, Weiben O, Uhl M et al. Assessment of the cranial involvement pattern of giant cell arteritis with 3T magnetic resonance imaging. Arthritis Rheum 2005; 52: 2470-2477
    CrossrefPubMedGoogle Scholar
  • 25 Schmidt WA, Moll A, Seifert A et al. Prognosis of large-vessel giant cell arteritis. Rheumatology 2008; 47: 1406-1408
    CrossrefPubMedGoogle Scholar
  • 26 García-Martínez A, Hernández-Rodríguez J, Arguis P et al. Development of aortic aneurysm/dilatation during the follow-up of patients with giant cell arteritis: A cross-sectional screening of fifty-four prospectively followed patients. Arthritis Rheum 2008; 59: 422-430
    CrossrefPubMedGoogle Scholar
  • 27 Macchioni P, Boiardi L, Catanoso M et al. Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica: comparison with the previous criteria in a single-centre study. Ann Rheum Dis 2013 Dec 2 [Epub ahead of print]
    PubMedGoogle Scholar
  • 28 Schmidt WA. Imaging in vasculitis. Best Pract Res Clin Rheumatol 2013; 27: 107-118
    CrossrefPubMedGoogle Scholar