FDG-PET/CT Findings in a Patient with Polymyalgia Rheumatica and Accompanying Remitting Seronegative Symmetrical Synovitis with Pitting Edema

Document Type : Brief Report

Authors

1 Department of Rheumatology, Odense University Hospital, Svendborg Hospital, Svendborg, Denmark

2 Department of NuclearMedicine, Odense University Hospital, Odense, Denmark

3 University of Southern Denmark, Odense, Denmark

Abstract

Background: Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare, but well-defined syndrome com- prising polyarthritis with symmetrical synovitis of the small joints in hands and feet accompanied by marked pitting edema. It is often considered a paraneoplastic syndrome, but here we report a case with F-18-fluorodeoxyglucose positron emission tomog- raphy/computed tomography (FDG-PET/CT) findings of polymyalgia rheumatica (PMR) in a patient with RS3PE and suspected of paraneoplastic syndrome.
Objectives: To briefly report the potential of FDG-PET/CT in rheumatic settings.
 
Methods: An 83-year-oldmalewith a history of prostate adenocarcinoma simultaneouslywith RS3PE presentedwith pain and stiff- ness of the shoulder and hip girdles to the department of rheumatology. He was anemic and had hypersedimentation of 106. He also complained of sore and swollen hands compatiblewith RS3PE. The patient had a previous course of RS3PE, presented as a para- neoplastic syndrome, togetherwith his prostate cancer one year earlier,which resolvedwhen the prostatic cancerwas in remission. FDG-PET/CT was performed due to suspicion of repeat paraneoplastic syndrome.
 
Results: FDG-PET/CT findings showed no evidence of malignant disease. Therewas diffusely increased FDG in soft tissue around the shoulders and hips and FDG-positive axillary lymph nodes consistent with PMR.
 
Conclusions: RS3PE and PMRmay belong to the same clinical entity. FDG-PET/CT has a potential role in themanagement of PMR as well as other rheumatic diseases.

Keywords

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi International Journal of Medicine
Volume 4, Issue 4
October 2016

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