Do we underestimate musculoskeletal ultrasonography in the diagnosis of polymyalgia rheumatica with or without giant cell arteritis? Polimiyaljia romatika ve dev hücreli arterit tanısında muskuloskeletal ultrasonografi kullanımını azımsıyor muyuz?

Uzun G. S., YARDIMCI G. K., Moral K., KILIÇ L., Bilgen Ş. A., KİRAZ S., ...Daha Fazla

Journal of Turkish Society For Rheumatology, cilt.15, sa.3, ss.143-148, 2023 (Scopus) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 3
  • Basım Tarihi: 2023
  • Doi Numarası: 10.4274/raed.galenos.2023.21939
  • Dergi Adı: Journal of Turkish Society For Rheumatology
  • Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.143-148
  • Anahtar Kelimeler: giant cell arteritis, musculoskeletal ultrasonography, Polymyalgia rheumatica, the new 2012 EULAR/ACR PMR provisional classification criteria
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Objective: We aimed to determine how often musculoskeletal ultrasonography (MSUS) is used in real-life practice for the evaluation of 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria in polymyalgia rheumatica (PMR) patients with or without giant cell arteritis (GCA). Methods: All patients have been prospectively registered in the Hacettepe University Vasculitis Research Center database since October 2014. The clinical information, laboratory and MSUS findings of patients registered in database until January 2023 were also retrospectively analyzed from the hospital electronic files and patients’ charts. MSUS findings were analyzed following the criteria. Patients were divided into two groups: those with or without GCA. The utility of the 2012 ACR/EULAR provisional PMR classification criteria was compared in two groups. Results: As of January 2023, 106 patients were included in the analysis. Eighteen patients were excluded from the study due to missing data and the diagnosis changed to inflammatory arthritis during the follow-up period. The mean age at diagnosis of the patients was 66.8 (7.53). Sixty (68.2%) of these patients had solely PMR, while twenty-eight (31.8%) had GCA accompanying PMR. Only 45 (75%) of 60 PMR patients and 12 (42.9%) patients with concomitant GCA diagnoses met the criteria. The criteria were higher solely in PMR patients (p=0.007). MSUS was applied to only 22.7% of patients. We found that only three patients did not meet the criteria if MSUS was not performed, and the rate of meeting the criteria in all patients changed from 64% to 61.3%. Conclusion: While the 2012 PMR provisional criteria are useful for solely PMR patients, they should be developed for patients with GCA accompanying PMR. In both groups, shoulder and hip ultrasonography was performed less frequently due to anatomical difficulties and insufficient training. Therefore, clinicians should pay attention to using MSUS and recommended criteria when diagnosing PMR in daily rheumatology practice.