Division of Rheumatology, "La Colletta" Hospital, Local Health Trust 3, Arenzano, Italy.
Autoimmunology Laboratory, University of Genoa, Genoa, Italy.
Rheumatology (Oxford). 2021 Mar 2;60(3):1016-1033. doi: 10.1093/rheumatology/keaa646.
PMR is an inflammatory rheumatic disease of elderly people characterized by pain and stiffness in the neck, shoulder and pelvic girdles. No specific diagnostic confirmatory tests exist and clinical symptoms, as well as increased acute phase reactants, are unspecific. The diagnostic value of imaging including ultrasound, MRI and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) with/without CT for PMR is increasingly studied. These techniques, particularly FDG-PET/CT, may help to detect underlying GCA in PMR patients with an incomplete response to glucocorticoids and/or recurrent relapses. Recent imaging studies provide novel insights into the anatomical basis of inflammation in PMR, particularly at hip and spine, which may help to distinguish this disease from other mimicking conditions. In this review, we discuss novel insights into the pathoanatomy of PMR, compare the diagnostic values of different imaging techniques and summarize current data on the role of imaging for monitoring and outcome prediction.
PMR 是一种老年人的炎症性风湿性疾病，其特征是颈部、肩部和骨盆带的疼痛和僵硬。目前不存在特定的诊断性确认试验，临床症状以及急性期反应物增加均不具有特异性。影像学检查（包括超声、MRI 和 18F-氟脱氧葡萄糖正电子发射断层扫描[FDG-PET]联合/不联合 CT）对 PMR 的诊断价值正在不断研究中。这些技术，特别是 FDG-PET/CT，可能有助于检测对糖皮质激素反应不完全和/或反复复发的 PMR 患者潜在的巨细胞动脉炎。最近的影像学研究为 PMR 炎症的解剖学基础提供了新的见解，特别是在髋关节和脊柱，这可能有助于将该疾病与其他类似疾病区分开来。在这篇综述中，我们讨论了 PMR 病理解剖学的新见解，比较了不同影像学技术的诊断价值，并总结了目前关于影像学在监测和预后预测中的作用的相关数据。
