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Ultrasonography in early assessment of elderly patients with polymyalgic symptoms: a role in predicting diagnostic outcome?
MedLine Citation:
PMID:  20653466     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective: To study the usefulness of ultrasonography (US) in predicting the diagnostic outcome in patients with polymyalgic symptoms. Methods: 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. Results: 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 = 0.027), and low power Doppler US (PDUS) scores at wrist (OR 0.052, p < 0.001). Conclusions: US and PDUS can be useful in distinguishing, at onset of disease, pure PMR from other diseases mimicking this condition.
Authors:
P Falsetti; C Acciai; A Volpe; L Lenzi
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Publication Detail:
Type:  Journal Article     Date:  2010-07-24
Journal Detail:
Title:  Scandinavian journal of rheumatology     Volume:  40     ISSN:  1502-7732     ISO Abbreviation:  Scand. J. Rheumatol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0321213     Medline TA:  Scand J Rheumatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  57-63     Citation Subset:  IM    
Affiliation:
Department of Rehabilitation, San Donato Hospital, Arezzo.
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