Musculoskeletal ultrasound findings in giant cell arteritis with polymyalgia rheumatica and isolated polymyalgia rheumatica

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ID: 328984
2026
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Ranked #41 of 143 articles by views in Rheumatology Advances in Practice

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Abstract
Abstract Objectives To compare musculoskeletal ultrasound (MSUS)-defined musculoskeletal involvement between patients with isolated polymyalgia rheumatica (PMR) and those with PMR symptoms in giant cell arteritis (GCA) and to explore the utility of MSUS findings combined with C-reactive protein (CRP) levels for identifying GCA. Methods We analyzed 20 patients with GCA–PMR and 40 with PMR from a prospectively maintained MSUS registry before treatment initiation. Both shoulders and knees were assessed using grayscale (GS) and power Doppler (PD) ultrasound. Tenosynovitis, bursitis, tendinitis, and ligamentitis were scored semiquantitatively. The association between ultrasound scores and serum CRP levels was evaluated. Exploratory multivariable regression analyses were performed to assess the potential utility of MSUS-based models in identifying GCA. Results Across all assessed sites, the prevalence and severity of MSUS-defined inflammatory findings were consistently lower in the GCA–PMR group than in the PMR group. Total GS and PD scores were significantly lower in the GCA–PMR group, despite comparable CRP levels between the groups. A model combining CRP levels and total GS+PD scores yielded an AUC of 0.94 for identifying GCA. A similar performance was observed with simplified models based on selected anatomical sites. Conclusions Patients with PMR symptoms in GCA exhibited lower MSUS-defined musculoskeletal involvement than those with isolated PMR. These findings suggest that reduced musculoskeletal inflammatory burden relative to systemic inflammation may be a characteristic feature of patients with GCA presenting with PMR symptoms. MSUS findings combined with CRP levels may provide complementary information when evaluating patients with PMR for possible GCA.
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Authors Sunao Kubota, Nakako Tanaka‐Mabuchi, Mayu Yazaki, Moe Nitta-Watanabe, Kojiro Ikeda, Ryosuke Ito, Yoshiaki Kobayashi, Kimie Harama, Kei Ito-Kobayashi, Shunichiro Hanai, Daiki Nakagomi
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Journal Rheumatology Advances in Practice
Year 2026
DOI
10.1093/rap/rkag110
URL
https://doi.org/10.1093/rap/rkag110
Keywords Keywords not found

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