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Ultrasound of shoulder synovitis may discriminate between polymyalgia rheumatica, elderly onset RA

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Using sonographic semi-quantitative assessments with serum matrix metalloproteinase-3 as a surrogate marker for scoring shoulder synovitis provided information useful for discriminating polymyalgia rheumatica from elderly onset rheumatoid arthritis, according to research presented at the European League Against Rheumatism Annual European Congress of Rheumatology.

Takeshi Suzuki

Takeshi Suzuki, MD, of the Japanese Red Cross Medical Center, Division of Allergy and Rheumatology, and colleagues analyzed the records of 15 patients with polymyalgia rheumatica (PMR) and 15 patients with elderly onset rheumatoid arthritis with PMR-like onset (polymyalgic-EORA). All patients underwent ultrasound assessments prior treatment start. Using a four-point scale, the severity of tenosynovitis of the long-head of the bicep, bursitis of shoulder (subdeltoid, subcrominal and subcoracoid bursitis) and joint synovitis of grenohumeral joint were subjectively scored for grey-scale and power Doppler synovitis. The researchers also assessed the correlation between the patient-shoulder synovitis score and serum markers.

“Using this scoring system, it was revealed that shoulder synovitis in PMR patients is milder than that in EORA patients with PMR-like onset,” Suzuki told Healio.com/Rheumatology in an interview.

The researchers found the ratio of patient-shoulder synovitis score to C-reactive protein (CRP) was significantly lower in PMR compared with polymyalgic-EORA. This was also true for the ratio between matrix metalloproteinase-3 (MPP-3) to CRP.

“Shoulder synovitis score is positively correlated with serum MMP-3, and both parameters can provide additional information to 2012 provisional classification criteria for PMR for distinguishing PMR from EORA with PMR-like onset,” Suzuki said. – by Monica Jaramillo

Reference:

Suzuki T, et al. Paper #AB1093. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.