Joint Bone Spine 81 (2014) 541
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Images in rheumatology
Fluorodeoxyglucose positron emission tomography in eosinophilic fasciitis Isabelle Marie ∗ , Gaetan Sauvetre Department of Internal medicine, CHU de Rouen, 76031 Rouen cedex, France
Fig. 1.
A 63-year-old woman presented with a 5-month history of myalgia involving mainly her lower limbs. On admission, physical examination showed edematous swelling involving her lower and upper limbs. Laboratory studies revealed: erythrocyte sedimentation rate: 32 mm/h, C-reactive protein: 30 mg/L, white blood cell count: 13.8 × 109 /L (14% eosinophils), creatine phosphokinase: 129 IU/L; renal and liver tests were normal. Autoantibody screening tests were negative; serum angiotensin-converting enzyme level was within normal limits. Viral (hepatitis B and C, cytomegalovirus, Epstein-Barr virus, coxsackie virus, human immunodeficiency virus), bacterial (Brucella, Borrelia burgdorferi) and toxoplasma serologies were negative. Positron emission tomography (PET) demonstrated a marked uptake of fluorodeoxyglucose (FDG) along the fascia of lower (Fig. 1A) and upper (Fig. 1B) limbs. Histological examination of fascia biopsy specimens showed inflammatory infiltrates in the muscle fascia composed of lymphoplasmocytic
∗ Corresponding author. E-mail address: [email protected] (I. Marie).
cells and eosinophils. The diagnosis of eosinophilic fasciitis was made. Our case report suggests that FDG-PET-scan may be a helpful test in eosinophilic fasciitis in providing accurate cartography of fascial changes and in guiding fascial biopsy. Moreover, because eosinophilic fasciitis has been reported to be associated with malignancy in up to 10% of cases [1], FDG-PET has the advantage, when compared with MRI, to exclude underlying malignancy.
Disclosure of interest The authors declare that they have no conflicts of interest concerning this article.
Reference [1] Lakhanpal S, Ginsburg WW, Michet CJ, et al. Eosinophilic fasciitis: clinical spectrum and therapeutic response in 52 cases. Semin Arthritis Rheum 1988;17:221–31.
http://dx.doi.org/10.1016/j.jbspin.2014.07.001 1297-319X/© 2014 Société franc¸aise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.
Available online at
ScienceDirect www.sciencedirect.com
Images in rheumatology
Fluorodeoxyglucose positron emission tomography in eosinophilic fasciitis Isabelle Marie ∗ , Gaetan Sauvetre Department of Internal medicine, CHU de Rouen, 76031 Rouen cedex, France
Fig. 1.
A 63-year-old woman presented with a 5-month history of myalgia involving mainly her lower limbs. On admission, physical examination showed edematous swelling involving her lower and upper limbs. Laboratory studies revealed: erythrocyte sedimentation rate: 32 mm/h, C-reactive protein: 30 mg/L, white blood cell count: 13.8 × 109 /L (14% eosinophils), creatine phosphokinase: 129 IU/L; renal and liver tests were normal. Autoantibody screening tests were negative; serum angiotensin-converting enzyme level was within normal limits. Viral (hepatitis B and C, cytomegalovirus, Epstein-Barr virus, coxsackie virus, human immunodeficiency virus), bacterial (Brucella, Borrelia burgdorferi) and toxoplasma serologies were negative. Positron emission tomography (PET) demonstrated a marked uptake of fluorodeoxyglucose (FDG) along the fascia of lower (Fig. 1A) and upper (Fig. 1B) limbs. Histological examination of fascia biopsy specimens showed inflammatory infiltrates in the muscle fascia composed of lymphoplasmocytic
∗ Corresponding author. E-mail address: [email protected] (I. Marie).
cells and eosinophils. The diagnosis of eosinophilic fasciitis was made. Our case report suggests that FDG-PET-scan may be a helpful test in eosinophilic fasciitis in providing accurate cartography of fascial changes and in guiding fascial biopsy. Moreover, because eosinophilic fasciitis has been reported to be associated with malignancy in up to 10% of cases [1], FDG-PET has the advantage, when compared with MRI, to exclude underlying malignancy.
Disclosure of interest The authors declare that they have no conflicts of interest concerning this article.
Reference [1] Lakhanpal S, Ginsburg WW, Michet CJ, et al. Eosinophilic fasciitis: clinical spectrum and therapeutic response in 52 cases. Semin Arthritis Rheum 1988;17:221–31.
http://dx.doi.org/10.1016/j.jbspin.2014.07.001 1297-319X/© 2014 Société franc¸aise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.
