Background Through the clinical experience of the power Doppler (PD) ultrasound (US) examination of the shoulder lesions in untreated patients with polymyalgia rheumatica (PMR), we noted that there were many cases presenting hyperemia adjacent to the anterior aspect of the subscapularis tendon (hyperemia on SubST).
Objectives We examined whether the hyperemia on SubST correlates with the disease activity of PMR.
Methods We analyzed consecutive records of 10 PMR patients and 12 elderly-onset rheumatoid arthritis (EORA) patients mimicking PMR, whose both shoulders were assessed routinely for the hyperemia on SubST using PDUS between July 2010 and September 2012 in our hospital. The areas of PD positive pixels on SubST (PD+ve area) were measured on representative transverse images of the shoulders using Image J (Image analysis software from NIH), and the correlation between the sum of PD+ve area of the bilateral shoulders and various clinical indicators was analyzed.
Results The mean of the PD+ve area was comparable between PMR group and EORA group. In PMR group, PD+ve area significantly correlated with serum concetration of matrix metalloproteinases (MMP)-3 (|R|=0.886, p= 0.0006). Although weak positive correlation was shown between PD+ve area and serum CRP or erythrocyte sedimentation rate (ESR) in PMR group, it was not statistically significant. There was no significant correlation between PD+ve area and serum MMP-3, serum CRP or ESR in EORA group.
Conclusions The strength of the increase in a blood flow adjacent to the anterior aspect of the subscapularis tendon detected by PDUS may serve as an index of a disease activity of PMR, possibly by representing periarticular inflammation.
Disclosure of Interest None Declared
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