Ultrasonography in early assessment of elderly patients with polymyalgic symptoms: a role in predicting diagnostic outcome?

Scandinavian Journal of Rheumatology
Paolo FalsettiL Lenzi

Abstract

To study the usefulness of ultrasonography (US) in predicting the diagnostic outcome in patients with polymyalgic symptoms. Sixty-one elderly patients with polymyalgic syndrome were recruited in a secondary care setting and followed up in a prospective way. Clinical, laboratory, and US data obtained at onset were re-evaluated after 1 year when diagnostic outcome was defined. A diagnostic shift was observed in 32 polymyalgic patients (52%). Calcium pyrophosphate deposition disease (CPDD) was diagnosed in nine patients, elderly-onset rheumatoid arthritis (EORA) in 18, and elderly-onset spondyloarthritis (EOSpA) in five. In polymyalgia rheumatica (PMR) patients US demonstrated synovitis in 90% of cases, in both proximal (90%) and peripheral joints (41%). The best predictive US model for the definitive diagnosis of PMR comprised: the presence of subacromial-subdeltoid bursitis [odds ratio (OR) 5.603, p = 0.003], low frequency of wrist (OR 0.074, p < 0.001), metacarpophalangeal (OR 0.052, p < 0.001), and metatarsophalangeal effusion/synovitis (OR 0.107, p < 0.027), low frequency of knee menisci chondrocalcinosis (OR 0.091, p = 0.013), tendinous calcaneal calcifications (OR 0.078, p = 0.006), and Achilles enthesitis (OR 0.107, p = 0....Continue Reading

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Citations

Dec 15, 2010·Modern Rheumatology·Takuya KotaniAkira Ukimura
Oct 12, 2012·Lancet·Tanaz A Kermani, Kenneth J Warrington
Oct 2, 2012·Therapeutic Advances in Musculoskeletal Disease·Pravin Patil, Bhaskar Dasgupta
Aug 3, 2013·Clinical Medicine : Journal of the Royal College of Physicians of London·Sarah Louise Mackie
Dec 4, 2015·Nature Reviews. Rheumatology·Frank Buttgereit, Eric L Matteson
Apr 30, 2013·Joint, Bone, Spine : Revue Du Rhumatisme·Paolo Falsetti, Caterina Acciai
Jun 4, 2015·Internal Medicine Journal·C E OwenA Hoi
Apr 16, 2016·Expert Review of Clinical Immunology·Francesco MuratoreCarlo Salvarani
Aug 5, 2016·Zeitschrift für Rheumatologie·C DejacoF Buttgereit
Feb 4, 2014·Therapeutic Advances in Musculoskeletal Disease·Tanaz A Kermani, Kenneth J Warrington
Sep 15, 2017·Nature Reviews. Rheumatology·Christian DejacoBhaskar Dasgupta
Jul 28, 2020·International Journal of Rheumatic Diseases·Kyung-Ann LeeHae-Rim Kim
Aug 2, 2019·Therapeutic Advances in Musculoskeletal Disease·Keigo HayashiJun Wada
Nov 18, 2020·Rheumatology·Dario CamellinoChristian Dejaco
Sep 4, 2021·Ultraschall in der Medizin : Organ der Deutschen Gesellschaft für Ultraschall in der Medizin, [der] Österreichischen Gesellschaft für Ultraschall in der Medizin, [der] Schweizerischen Gesellschaft für Ultraschall in Medizin und Biologie·Daniela FodorEsperanza Naredo

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