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￭ ♣ S-565 ￭
Muscular involvement in polymyalgia rheumatica
Division of Rheumatology, 1Department of Internal Medicine, Department of Radiology, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
*Gi Bum Bae, Jae Hyuck Yi
1, Na Ri Kim, Jong Wan Kang, Ji Hun Kim, Churl Hyun Im, Eon Jung Nam, Young Mo Kang
Objective: Synovitis and bursitis have been demonstrated in polymyalgia rheumatica (PMR). But myositis has been rarely reported in PMR.Magnetic resonance imaging (MRI) has been used in PMR because of its potential to localize inflamed tissues. We sought to investigate the muscular involvement in PMR. Methods: We analyzed MRI findings of shoulder and pelvic girdle of 12 patients diagnosed by Chuang’s diagnostic criteria for PMR at Kyungpook National University Hospital. Inflammations in joint, bursa and muscle were examined. Results: The male to female ratio was 1 : 1. Mean age at diagnosis was 64.2 years. MRI of shoulder (5 patients) showed subacromial subdeltoid bursitis (60%), synovitis of gleno-humeral joint (40%), synovitis of acromioclavicular joint (20%) and juxtaentheseal myopathy (20%). MRI of pelvis (10 patients) showed synovitis of hip joint (20%), trochanteric bursitis (30%), ischial bursitis (20%), juxtaentheseal myopathy (60%) and myopathy (20%). Overall muscular involvement rate of PMR was 58.3%. Iliopsoas and hip rotators were the most common involved muscles and hamstring, gluteus maximus, and gluteus medius were followed in order of frequency. Muscular involvement were characterized by juxtaentheseal myopathy which was defined as inflammation of muscle around the site of bone attachment and near the fascia and by patch distribution of small areas of muscle fibers. Conclusions: MRI of PMR revealed characteristic findings of juxtaentheseal myopathy in addition to bursitis and synovitis.
This study suggest that juxtaentheseal myopathy in pelvis may contribute to the diffuse pain and stiffness in the pelvic girdle observed in patients with PMR at least partially.
￭ ♣ S-566 ￭
Observational study on the effects of immunosuppressive therapy in uveitis associated with rheumatic diseases.
Department of Internal Medicine, Dong -A University Hospital
*Lee Sang Yeob, Kim Yong Jun, Kang San Hyeon, Lee Dong Yeol, Cho Duk Song, Kim Kyong Han, Lee Sung Won, Chung Won Tae.
The purpose of this study was to compare with uveitis accompanied rheumatic disease and uveitis unaccompanied rheumatic disease in immunosuppressive therapy response. An observational study was conducted of 432 patients diagnosed with uveitis who visited the rheumatologic department to evaluate with rheumatic disease between 2000 and 2009. We divided patients into two groups: uveitis related to rheumatic disease and unrelated to rheumatic disease. All patients were treated and a response to treatment was measured at the end of the observation period.
The 432 patients were diagnosed to uveitis, 33 (7.6%) patients had rheumatic diseases related uveitis and 399 (92.4%) patients had uveitis unrelated rheumatic disease. the each group were similar to gender and body mass index. but the mean age at onset of uveitis was younger uveitis with rheumatic disease than uveitis without rheumatic disease(44.06 vs 48.23 years). The rheumatic disease accompanied uveitis was consisted of spondyloarhtropathy (31%), bechet’s disease (27%), rheumatoid arthritis (18%), systemic lupus erythematosus (15%), sjogren’s syndrome (6%) and mixed connective tissue disease (3%). The state of inflammation, ESR and CRP levels in patients with uveitis associated with rheumatic diseases were increased but the ocular complications did not increase in uveitis associated with rheumatic disease. The response of immunosuppressive therapy in patients with uveitis associated with rheumatic diseases was good and was statistically significant (p<0.05). The uveitis accompanied rheumatic disease was better response to immunosuppressive therapy and less frequent complications than uveitis unaccompanied rheumatic disease in early treatment.
