New Imaging Techniques to Improve Diagnosis and Treatment of Polymyalgia Rheumatica in Adults Over 50

What this Trial Is About

Polymyalgia rheumatica PMR is a common chronic inflammatory disease in older adults, causing pain and fatigue in the upper arms and thighs. This research aims to improve PMR diagnosis by evaluating a new imaging method using positron emission tomography and computed tomography PETCT combined with magnetic resonance imaging MRI. The study also assesses a treatment approach guided by clinical diagnosis combined with PET scans in patients newly diagnosed with PMR. The study will include 111 patients suspected of PMR to compare PETCT and MRI images at the start and after 8 weeks of prednisolone treatment. Among these, 100 patients with newly diagnosed PMR will have their treatment started based on clinical diagnosis and PET results. Those with suspected PMR but a negative PET scan will receive intramuscular glucocorticoids instead of routine oral prednisolone, with dosage tapered over a maximum of 3 months as decided by the investigator. Participants will undergo PETMRI or PETCT scans at baseline and after 8 weeks of treatment. Researchers will track clinical diagnosis outcomes over one year, including the need for glucocorticoids, symptom remission or relapse, and physical activity levels using a step-count app. Safety, disease activity, and imaging changes will be monitored, with follow-up assessments planned up to 5 years to evaluate long-term outcomes and treatment effectiveness.

Using Novel Imaging to Rethink Diagnostic and Treatment Strategies for Polymyalgia Rheumatica