Background Early diagnosis and treatment of aortitis are important to prevent possible serious complications such us aneurysm, aneurismal ruptured or aortic dissection. Aortitis may present with non-specific symptoms. Positron emission tomography (PET) is useful in diagnosing aortitis. However, PET is an expensive technique.
Objectives Our aim was to evaluate those PET performed by suspected aortitis in order to find some predictive factors for positive PET for aortitis.
Methods Study of PET performed by suspected aortitis in a University Hospital (from January 2013 to December 2015). The main epidemiological, clinical and laboratory data of these patients were extracted from clinical records according to a specifically designed protocol, reviewed for confirmation of the diagnosis, and stored in a computerized file. To minimize entry error all data were double checked.
A comparative study was made between positive and negative PET to identify red flags of an underlaying aortitis.
Quantitative variable results were expressed as mean±standard deviation (SD) or median [IQR] and were analyzed by Mann-Whitney U test. Qualitative variable results were expressed as percentages and frequency and were analyzed by Fisher's exact test. Statistic analysis was performed with the SAS System for Windows V 9.2.
Results In last 3 year period 33 PET were requested to confirm aortitis (5 of them in 2013, 7 in 2014 and 21 in 2015). We had 3 positive results of 5 (60%) in 2013, 3 of 7 (42.85%) in 2014 and 7 of 21 (33.33%) in 2015. The mean age of the 33 (22 female/11 male) patients was 70.30±14.16 years (range, 31–89).
The underlying diseases associated to these patients were: giant cell arteritis (GCA) (n=12), polymyalgia rheumatic (PmR) (n=8), connective tissue diseases (Sjögren syndrome, dermatomyositis, undifferentiated connective pathology) (n=5), seronegative polyarthritis (n=3), relapsing polychondritis (n=2), idiophatic (n=2), hiper-IgG syndrome (n=1).
Comparative study between positive and negative PET is summarized in TABLE. Inflammatory back pain and irradiated lower limb pain conditions were more common among patients with positive PET. They were the unique variables with statistically significant difference. The rest of both epidemiologic, clinical, laboratory or the possible influence of treatment with steroids and/or immunosuppressants at the time of conducting PET did not differ between groups.
Conclusions In this estudy we observed an increasing in demand for PET for suspected aortitis every year and more cases were diagnosed in recent years. However, positive test percentage progressively decreased. The presence of inflammatory back pain and pain radiating to the lower extremities may have clinical relevance to suspect aortitis and a positive PET result. Prospective studies are needed with larger numbers of patients to establish a predictive model for aortitis.
Disclosure of Interest None declared