PT  - JOURNAL ARTICLE
AU  - Fabrizio Cantini
AU  - Carlo Salvarani
AU  - Laura Niccoli
AU  - Carlotta Nannini
AU  - Luigi Boiardi
AU  - Angela Padula
AU  - Ignazio Olivieri
AU  - Massimo Valentino
AU  - Libero Barozzi
TI  - Fat suppression magnetic resonance imaging in shoulders of patients with polymyalgia rheumatica.
DP  - 2004 Jan 01
TA  - The Journal of Rheumatology
PG  - 120--124
VI  - 31
IP  - 1
4099  - http://www.jrheum.org/content/31/1/120.short
4100  - http://www.jrheum.org/content/31/1/120.full
SO  - J Rheumatol2004 Jan 01; 31
AB  - OBJECTIVE: To evaluate the sites of inflammatory process in the shoulders of patients with polymyalgia rheumatica (PMR) using fat suppressed magnetic resonance imaging (MRI). METHODS: Six consecutive, untreated new patients with PMR were investigated. Five patients with early rheumatoid arthritis (RA) and 4 patients with early psoriatic arthritis (PsA) with bilateral shoulder symptoms served as a control group. Bilateral shoulder fat-suppressed MRI sequences were performed in all patients and controls. We evaluated the presence of joint synovitis, bursitis, tenosynovitis, and bone and soft tissue edema. RESULTS: Bilateral subacromial/subdeltoid bursitis was found in all patients with PMR, in 1/5 (20%) patients with RA (p < 0.05), and in none with PsA (p < 0.02). Glenohumeral synovitis was present in all case and controls. Biceps tenosynovitis was observed in 4/6 (67%) patients with PMR, in 4/5 (80%) with RA (not significant, NS), and in all 4 patients with PsA (NS). No evidence of bone edema adjacent to the joint capsule and entheseal insertions or in the soft tissues was present in either cases or controls. CONCLUSION: The absence of extracapsular abnormalities in the early shoulder disease of PMR does not confirm the hypothesis of a capsular-based disorder.