Review Article

The Role of 18F-FDG PET/CT in Large-Vessel Vasculitis: Appropriateness of Current Classification Criteria?

Figure 2

A 48-year-old man presented with initial painful calves followed by progressive painful arms and legs, shoulders, and knees. No hydrops or other clinical signs of arthritis. Normal body temperatures; CRP level, 84 mg/L; ESR, 41 mm/h; normal routine laboratory values; rheumatoid factor negative; cyclic citrullinated peptide antibody test negative; serum angiotensin-converting enzyme, 10.3 units/L; antinuclear antibody test negative; and anticytoplasmic autoantibodies negative. Urine sediment: albumin trace. Glomerular basal membrane antibody test negative. Viral serology negative. Chest X-ray and abdominal ultrasonography without abnormalities. X-ray of hands, feet, and knees revealed no erosive changes. Ultrasonography of the hips revealed no abnormalities. Also 18F-FDG PET/CT showed pathological perisynovial uptake at the major joints, as well as pathological lumbar interspinous uptake in the soft tissue (bursae) lateral to both of the greater trochanters and dorsal to both of the tuber ischii. The diagnosis of PMR was made; after treatment with steroids, the patient became pain free, and the CRP values remained less than 10 mg/L [25].
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