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Ultrasound in assessment of cervical interspinous bursitis in polymyalgia rheumatica

Polymyalgia rheumatica (PMR) is the commonest inflammatory rheumatic disease of the elderly and it is characterized by inflammatory pain and stiffness in the shoulder and in the pelvic girdle and neck [1,2] . Imaging can demonstrate several targets of inflammatory damage in PMR, as joint synovitis, tenosynovitis, bursitis and vasculitis. Magnetic resonance imaging (MRI) observations demonstrated that cervical interspinous bursitis can explain the frequently observed PMR-associated neck pain [3] . Recent fluorodeoxyglucose positron emission tomography (FDG-PET) studies confirmed FDG uptake in vertebral spinous processes in about half of PMR, with a high specificity for PMR in particular with respect of elderly-onset rheumatoid arthritis (EORA) [4–6] . Ultrasonography (US) has proved to increase diagnostic effectiveness in PMR, [2,6–8] but it has never been applied to the study of PMR spinal involvement.</P>Three consecutive patients with typical clinical features of PMR and neck pain were studied with US. All patients (two males, one female, mean age 79 years, range 73–86) satisfied both Bird et al. [9] and recent provisional ACR/EULAR classification criteria for PMR [2] . US examination were carried out using a portable SonoSite (Bothell, USA) Titan with a 5–10 MHz linear transducer. Each US examination was carried out with http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Joint Bone Spine Elsevier
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