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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Decoding polymyalgia rheumatica, the role of Nuclear Medicine Imaging
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Vol. 43. Issue 1.
Pages 63-72 (January - February 2024)
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Vol. 43. Issue 1.
Pages 63-72 (January - February 2024)
Continuing Education
Decoding polymyalgia rheumatica, the role of Nuclear Medicine Imaging
Desenmascarando la polimialgia reumática, papel de la Medicina Nuclear
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E. Noriega-Álvareza,b,
Corresponding author
edelnoriega@gmail.com

Corresponding author.
, B. Rodríguez-Alfonsoc,b, C. Merino Argumánezd, L. Domínguez Gadeae,b, V. Peiró-Valgañónf,b
a Servicio de Medicina Nuclear, Hospital General Universitario de Ciudad Real, Guadalajara, Spain
b Grupo de Trabajo de Patología Músculo-Esquelética de la SEMNIM, Spain
c Servicio de Medicina Nuclear, Hospital Puerta de Hierro de Majadahonda, Madrid, Spain
d Servicio de Reumatología, Hospital Puerta de Hierro de Majadahonda, Madrid, Spain
e Servicio de Medicina Nuclear, Hospital Universitario La Paz, Madrid, Spain
f Departamento de Medicina Nuclear, Diagnóstico por la Imagen, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Tables (3)
Table 1. Differential diagnosis of polymyalgia rheumatica.
Table 2. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice.3
Table 3. Advantages and disadvantages of the imaging methods in the diagnosis of PMR.
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Abstract

Polymyalgia rheumatica (PMR) is an inflammatory joint disease that presents in patients older than 50 years with prolonged morning pain and stiffness in the shoulder and hip joints and neck. The lack of specific clinical findings, laboratory signs, biomarkers and established imaging methods makes it difficult to diagnose patients with this disease. 18F-FDG PET/CT is a functional imaging technique that is an established tool in oncology and has also proven useful in the field of inflammatory diseases. The aim of this paper is to present literature evidence on the use of molecular imaging methods such as PET/CT for early diagnosis, assessment of disease activity and therapeutic response in PMR. At the same time, the advantages, disadvantages and contraindications of other methods are considered.

Keywords:
Polymyalgia rheumatica
18F-FDG PET/CT
Positron emission tomography/computed tomography
Inflammation
Therapeutic evaluation
Diagnosis
Resumen

La polimialgia reumática (PMR) es una enfermedad inflamatoria de las articulaciones que se presenta en pacientes mayores de 50 años con dolor y rigidez matutina prolongada en las cinturas del hombro y la cadera y en el cuello. La falta de hallazgos clínicos específicos, signos de laboratorio, biomarcadores y métodos de imagen establecidos dificulta el diagnóstico de los pacientes con esta enfermedad. La 18F-FDG PET/TC es una técnica de imagen funcional que constituye una herramienta consolidada en oncología y que también ha demostrado su utilidad en el campo de las enfermedades inflamatorias. El objetivo de este trabajo es presentar evidencia bibliográfica sobre el uso de métodos de imagen molecular como la PET/TC para el diagnóstico precoz, la evaluación de la actividad de la enfermedad y la respuesta terapéutica en la PMR. Al mismo tiempo, se consideran las ventajas, desventajas y contraindicaciones de otros métodos.

Palabras clave:
Polimialgia reumática
18F-FDG PET/TC
Tomografía por emisión de positrones/tomografía computarizada
Inflamación
Evaluación terapéutica
Diagnóstico

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