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Correspondence response
Response to: ‘A relationship between extracapsular involvement and response to steroid treatment in polymyalgia rheumatica: too soon to conclude?’ by Yang et al
  1. Sarah L Mackie,
  2. Dennis G McGonagle
  1. University of Leeds. Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, Leeds, UK
  1. Correspondence to Dr Sarah L Mackie, University of Leeds.Leeds Institute of Rheumatic and Musculoskeletal Medicine, Chapel Allerton Hospital, Leeds LS7 4SA, UK; s.l.mackie{at}

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We thank Yang et al1 for their comments on our whole body MRI study in patients with polymyalgia rheumatica (PMR). Our previous work in PMR revealed inflammatory changes outside the joint cavity, or ‘extracapsular pattern disease’, in both the shoulder and the hand.2 ,3 In a preliminary analysis of four non-contrast whole-body MRIs in the present cohort, we saw an identical pattern of disease in PMR and consequently developed the scoring system described. In addition to scoring the individual sites semi-quantitatively, we also classified the overall pattern as ‘extracapsular’ or not, using visual pattern recognition. This Gestalt-based classification was not derived directly from any of the individual site scores.

Subsequently, after unblinding of clinical diagnosis, we derived an …

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