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L E Green - One of the best experts on this subject based on the ideXlab platform.
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a cross sectional study of the prevalence and associated risk factors for capped hock and the associations with Bursitis in weaner grower and finisher pigs from 93 commercial farms in england
Preventive Veterinary Medicine, 2008Co-Authors: Amy L. Kilbride, Claire E Gillman, Pete Ossent, L E GreenAbstract:The prevalence of capped hock in 5601 post-weaning pigs from 93 pig farms in England was 17.2%. The prevalence increased with age. Once adjusted for age, the lowest prevalence of capped hock was observed in pigs kept on soil floors (usually covered with deep straw bedding). There was no significant increase in the risk of capped hock in pigs kept on solid concrete floors with deep straw bedding. However, pigs kept on solid concrete with some, or the entire pen, sparsely bedded and pigs kept on partially or fully slatted floors had an approximately threefold increased risk of capped hock. This did not vary significantly between these four floor types. This was in contrast to the associated risks for Bursitis in the same pigs, where as the floor went from highly resilient (straw and solid floors) to hard and perforated (fully slatted) the risk of Bursitis increased in a similar way to a dose response. No other variables that were measured were associated with a change in risk for capped hock, while observation of pigs slipping or slip marks and wet, dirty and worn pens were also associated risks for Bursitis. These results indicate that capped hock and Bursitis are both affected by exposure to floors, but in different ways. The prevalence of capped hock was associated only with floor hardness, with deep straw protecting the pigs, while Bursitis was associated with both changes in bedding depth (hardness), floor material (soil versus concrete) and floor construction (solid versus slatted floors) and in factors associated with locomotion (slipping and slip marks). These results indicate that the aetiology of capped hock and Bursitis might differ.
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a cross sectional study of the prevalence and associated risk factors for Bursitis in weaner grower and finisher pigs from 93 commercial farms in england
Preventive Veterinary Medicine, 2008Co-Authors: Claire E Gillman, Amy L. Kilbride, Pete Ossent, L E GreenAbstract:A cross-sectional study of 93 farms in England was carried out to estimate the prevalence and associated risk factors for Bursitis. A total of 6250 pigs aged 6-22 weeks were examined for presence and severity of Bursitis. Details of pen construction, pen quality and farm management were recorded including floor type, presence of bedding, condition of the floor and floor materials. The prevalence of Bursitis was 41.2% and increased with each week of age (OR 1.1). Two-level logistic regression models were developed with the outcome as the proportion of pigs affected with Bursitis in a pen. Pigs kept on soil floors with straw bedding were used as the reference level. In comparison with these soil floors, Bursitis increased on concrete floors where the bedding was deep throughout (OR 4.6), deep in part (OR 3.7), and sparse throughout (OR 9.0), part slatted floors (OR 8.0), and fully slatted floors (OR 18.8). Slip or skid marks in the dunging area (OR 1.5), pigs observed slipping during the examination of the pen (OR 1.3) and wet floors (OR 3.6) were also associated with an increased risk of Bursitis. The results indicate that Bursitis is a common condition of growing pigs and that the associated risk factors for Bursitis were a lack of bedding in the lying area, presence of voids and pen conditions which increased the likelihood of injury.
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adventitious Bursitis of the hock in finishing pigs prevalence distribution and association with floor type and foot lesions
Veterinary Record, 1998Co-Authors: N. Mouttotou, L E Green, F. M. HatchellAbstract:The prevalence, severity and distribution of adventitious Bursitis were estimated in 3989 finishing pigs from 21 units in south-west England. The overall prevalence of adventitious Bursitis was 51.0 per cent and ranged from 10.1 to 84.0 per cent in the different units. Bursae were found on four different aspects of the hock: lateroplantar, plantar, medial and point of the hock (capped hock). The median severity of the bursae at all the different sites was mild (score 1). There was a large variation in the prevalence of different bursal lesions. Lateroplantar bursae (41.8 per cent) were the most prevalent followed by plantar (12.0 per cent), medial (4.8 per cent) and capped hock (3.7 per cent). There was a significant trend in the prevalence of Bursitis with floor type; pigs kept on solid concrete floors with deep straw (>10 cm) had the lowest risk of having Bursitis, and the prevalence increased successively when the floors were solid concrete with sparse straw (<10 cm), semi-slatted and fully slatted. There was a significant association between the presence of Bursitis and foot lesions.
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cohort study of the association between adventitious Bursitis of the hock and the age at slaughter and carcase quality of the pigs on one farm
Veterinary Record, 1998Co-Authors: N. Mouttotou, J Sterry, L E GreenAbstract:The prevalence and severity of adventitious Bursitis and its association with age at slaughter and carcase quality were evaluated in a cohort of 1011 pigs reared in a straw.based system. The prevalence of Bursitis was 85.4 per cent (574/672). Pigs with Bursitis had a significantly greater depth of fat over the ribs (P=0.01) and at P2 (P=0.02). There was evidence (P=0.06) of an association between Bursitis and a reduction in the depth of the rib muscle. There was also a significant reduction in the lean meat content of the carcases of the pigs with Bursitis (P<0.01). There was no association with age at slaughter, sex or carcase weight. When the significant associations were considered in a forward stepwise unconditional logistic regression model, with the presence of Bursitis as the dependent variable, the only significant variable was depth of rib fat with an odds ratio of 1.12 (95 per cent confidence interval 1.02 to 1.22). The economic impact of adventitious Bursitis on carcase quality was estimated to be equivalent to a loss of 0.5 kg per affected pig.
Carlo Salvarani - One of the best experts on this subject based on the ideXlab platform.
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lumbar interspinous Bursitis in active polymyalgia rheumatica
Clinical and Experimental Rheumatology, 2013Co-Authors: Carlo Salvarani, Libero Barozzi, Luigi Boiardi, Nicolo Pipitone, Gianluigi Bajocchi, Pierluigi Macchioni, Mariagrazia Catanoso, Giulia Pazzola, Massimo Valentino, De Luca CAbstract:OBJECTIVES: To evaluate the inflammatory involvement of lumbar interspinous bursae in patients with polymyalgia rheumatica (PMR) using magnetic resonance imaging (MRI). METHODS: Ten consecutive, untreated new patients with PMR and pain in the shoulder and pelvic girdles were investigated. Seven patients with spondyloarthritis (4 with psoriatic spondyloarthrits, one with entheropatic spondyloarthritis, and 2 with ankylosing spondylitis) as well as 2 patients with spinal osteoarthritis and 2 patients with rheumatoid arthritis with lumbar pain served as controls. MRI of lumbar spine was performed in all PMR patients and controls. Nine patients (5 PMR patients and 4 controls) also had MRI of the thoracic spine. RESULTS: MRI evidence of interspinous lumbar Bursitis was found in 9/10 patients with PMR and in 5/11 controls. A moderate to marked (grade ≥2 on a semiquantitative 0-3 scale) lumbar Bursitis occurred significantly more frequently in patients with PMR than in control patients (60% vs. 9%, p=0.020). In most of the patients and controls lumbar Bursitis was found at the L3-L5 interspaces. Only 2 patients had Bursitis at a different level (one patient had widespread lumbar Bursitis, and one control at L2-L4). No interspinous Bursitis was demonstrated by MRI of the thoracic spine in patients and controls. CONCLUSIONS: Inflammation of lumbar bursae may be responsible for the low back pain reported by patients with PMR. The prominent inflammatory involvement of bursae including those of the lumbar spine supports the hypothesis that PMR may be a disorder affecting predominantly extra-articular synovial structures.
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cervical interspinous Bursitis in active polymyalgia rheumatica
Annals of the Rheumatic Diseases, 2008Co-Authors: Carlo Salvarani, Libero Barozzi, Luigi Boiardi, Nicolo Pipitone, Gianluigi Bajocchi, Pierluigi Macchioni, Massimo Valentino, Fabrizio Cantini, Laura Niccoli, Mariagrazia CatanosoAbstract:Objective: To evaluate the inflammatory involvement of cervical interspinous bursae in patients with polymyalgia rheumatica (PMR) using magnetic resonance imaging (MRI). Methods: Twelve consecutive, untreated new patients with PMR were investigated. Five patients with fibromyalgia, 2 patients with cervical osteoarthritis and 6 patients with spondyloarthritis with neck pain served as controls. MRI of the cervical spine was performed in all 12 PMR case-patients and in 13 control-patients. Two of the 4 PMR patients with pelvic girdle pain also had MRI of the lumbar spine. Results: MRI evidence of interspinous cervical Bursitis was found in all patients with PMR, and in 3 patients with fibromyalgia, in 2 with psoriatic spondylitis and 1 with cervical osteoarthritis. A moderate to marked (grade >2 on a semiquantitative 0-3 scale) cervical Bursitis occurred significantly more frequently in patients with PMR than in control-patients (83.3% compared with 30.7%, p=0.015). In all patients and controls with cervical Bursitis the involvement was found at the C5-C7 cervical interspaces. MRI of the lumbar spine showed lumbar interspinous Bursitis at the L3-L5 lumbar interspaces in the 2 patients with PMR and pelvic girdle pain examined. Conclusions: Cervical interspinous Bursitis is a likely basis for discomfort in the neck of patients with PMR. The prominent inflammatory involvement of cervical bursae supports the hypothesis that PMR is a disorder of prominent involvement of extra-articular synovial structures.
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inflammatory changes of hip synovial structures in polymyalgia rheumatica
Clinical and Experimental Rheumatology, 2005Co-Authors: Fabrizio Cantini, Luigi Boiardi, Laura Niccoli, Carlotta Nannini, Angela Padula, Ignazio Olivieri, Carlo SalvaraniAbstract:OBJECTIVE: To investigate the hip inflammatory lesions and to evaluate the accuracy of clinical examination compared to magnetic resonance imaging (MRI) in patients with polymyalgia rheumatica (PMR) with pelvic girdle symptoms. Secondary end-point was to evaluate the sensitivity and specificity of ultrasonography (US) compared to MRI in the assessment of hip lesions. METHODS: Case-control study of 20 consecutive PMR patients and 40 controls with different rheumatic conditions. Both groups were clinically assessed for the presence of hip synovitis, trochanteric, iliopsoas and ischiogluteal Bursitis. Hip MRI was performed in all case-patients and in 10 controls. Both groups were examined by US. An additional group of 10 healthy controls was examined by hip US. RESULTS: Both MRI and US detected trochanteric Bursitis in 100% of PMR patients, bilateral in 18/20 (90%), and in 12/40 (30%) controls (p < 0.001). Hip synovitis was detected in 17/20 (85%) by MRI and in 9/20 (45%) by US (p < 0.02) in case-patients and in 18/40 (45%) controls. In PMR, MRI and US showed iliopsoas Bursitis in 10/20 (50%) and 6/20 (30%) and ischiogluteal Bursitis in 5/20 (25%) and 4/20 (20%) with no differences compared to controls. Clinical examination showed a good accuracy for hip synovitis, trochanteric and ischiogluteal Bursitis, while it overestimated the presence of iliopsoas Bursitis. US was less sensitive than MRI for the detection of hip synovitis and iliopsoas Bursitis (53% and 60%). CONCLUSION: Trochanteric Bursitis represents the most frequent hip lesion in PMR. A careful physical examination allows to detect all inflammatory lesions excluding iliopsoas Bursitis. US is less sensitive than MRI in the assessment of hip synovitis and iliopsoas Bursitis.
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shoulder ultrasonography in the diagnosis of polymyalgia rheumatica a case control study
The Journal of Rheumatology, 2001Co-Authors: Fabrizio Cantini, Carlo Salvarani, Luigi Boiardi, Laura Niccoli, Angela Padula, Ignazio Olivieri, Luigi Macchioni, Giovanni Ciancio, Mariano Mastrorosato, Fabrizio RubiniAbstract:OBJECTIVE: Magnetic resonance imaging (MRI) showed that subacromial/subdeltoid Bursitis is the most frequent shoulder lesion in polymyalgia rheumatica (PMR). We evaluated whether shoulder ultrasonography (US) was as effective as MRI in the detection of this lesion and assessed the sensitivity and specificity of bilateral subacromial/subdeltoid Bursitis in the diagnosis of PMR. METHODS: A case-control study of 57 consecutive case patients with untreated PMR and 114 controls seen over a 6 month period in 3 secondary referral rheumatology centers. Control patients consisted of the next 2 consecutive patients with bilateral shoulder aching and stiffness observed after the case patient. In all case and control patients the glenohumeral joint space, bursae, and long head biceps tendon were assessed by bilateral shoulder US. The first 24 case patients were also examined by bilateral shoulder MRI. RESULTS: US showed subacromial/subdeltoid Bursitis in 55/57 (96%) patients with PMR and in 25/114 (22%) controls (p < 0.001). The lesion was bilateral in 53/55 (96%) case patients and in 1/25 (4%) controls (p < 0.001). The frequency of glenohumeral joint synovitis and biceps tenosynovitis did not differ significantly between case patients and controls. In 100% of case patients MRI showed subacromial/subdeltoid Bursitis confirming US findings. The sonographic evidence of bilateral Bursitis had a sensitivity of 92.9%, specificity of 99. 1%, and positive predictive value of 98. 1% for the diagnosis of PMR. CONCLUSION: US and MRI were equally effective in confirming bilateral subacromial and subdeltoid Bursitis in PMR. This finding, in view of its high sensitivity and specificity, could be used as a new diagnostic criterion for PMR.
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retrocalcaneal Bursitis in spondyloarthropathy assessment by ultrasonography and magnetic resonance imaging
The Journal of Rheumatology, 1998Co-Authors: Ignazio Olivieri, Carlo Salvarani, Libero Barozzi, Fabrizio Cantini, Angela Padula, M De Matteis, A Pierro, Pietro PavlicaAbstract:Objective. To establish by magnetic resonance imaging (MRI) and ultrasonography (US) the frequency of retrocalcaneal bursa involvement in Achilles enthesitis of spondyloarthropathy (SpA) and to compare the results of the 2 examinations. Methods. Nineteen Achilles tendons with severe enthesitis and 9 normal tendons of 14 patients meeting the Amor criteria for SpA were examined by MRI and US. Results. Both MRI and US showed a significant increase in the mean Achilles tendon thickness in the pathologic legs compared to the normal legs both at the superior calcaneal surface and 3 cm above. MRI showed retrocalcaneal Bursitis in 14 (73.7%) of 19 pathologic legs and superficial Bursitis in 2 (10.5%). US showed fluid collection only in 7 of 14 retrocalcaneal bursae positive on MRI, and failed to show fluid in the 2 superficial bursae involved. Using MRI as the gold standard, US showed 50% sensitivity and 100% specificity for retrocalcaneal bursa involvement and lacked sensitivity for superficial Bursitis. Conclusion. Achilles tendon involvement in SpA is not only a disease of the enthesis but also of the adjacent bursae.
Claire E Gillman - One of the best experts on this subject based on the ideXlab platform.
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a cross sectional study of the prevalence and associated risk factors for capped hock and the associations with Bursitis in weaner grower and finisher pigs from 93 commercial farms in england
Preventive Veterinary Medicine, 2008Co-Authors: Amy L. Kilbride, Claire E Gillman, Pete Ossent, L E GreenAbstract:The prevalence of capped hock in 5601 post-weaning pigs from 93 pig farms in England was 17.2%. The prevalence increased with age. Once adjusted for age, the lowest prevalence of capped hock was observed in pigs kept on soil floors (usually covered with deep straw bedding). There was no significant increase in the risk of capped hock in pigs kept on solid concrete floors with deep straw bedding. However, pigs kept on solid concrete with some, or the entire pen, sparsely bedded and pigs kept on partially or fully slatted floors had an approximately threefold increased risk of capped hock. This did not vary significantly between these four floor types. This was in contrast to the associated risks for Bursitis in the same pigs, where as the floor went from highly resilient (straw and solid floors) to hard and perforated (fully slatted) the risk of Bursitis increased in a similar way to a dose response. No other variables that were measured were associated with a change in risk for capped hock, while observation of pigs slipping or slip marks and wet, dirty and worn pens were also associated risks for Bursitis. These results indicate that capped hock and Bursitis are both affected by exposure to floors, but in different ways. The prevalence of capped hock was associated only with floor hardness, with deep straw protecting the pigs, while Bursitis was associated with both changes in bedding depth (hardness), floor material (soil versus concrete) and floor construction (solid versus slatted floors) and in factors associated with locomotion (slipping and slip marks). These results indicate that the aetiology of capped hock and Bursitis might differ.
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a cross sectional study of the prevalence and associated risk factors for Bursitis in weaner grower and finisher pigs from 93 commercial farms in england
Preventive Veterinary Medicine, 2008Co-Authors: Claire E Gillman, Amy L. Kilbride, Pete Ossent, L E GreenAbstract:A cross-sectional study of 93 farms in England was carried out to estimate the prevalence and associated risk factors for Bursitis. A total of 6250 pigs aged 6-22 weeks were examined for presence and severity of Bursitis. Details of pen construction, pen quality and farm management were recorded including floor type, presence of bedding, condition of the floor and floor materials. The prevalence of Bursitis was 41.2% and increased with each week of age (OR 1.1). Two-level logistic regression models were developed with the outcome as the proportion of pigs affected with Bursitis in a pen. Pigs kept on soil floors with straw bedding were used as the reference level. In comparison with these soil floors, Bursitis increased on concrete floors where the bedding was deep throughout (OR 4.6), deep in part (OR 3.7), and sparse throughout (OR 9.0), part slatted floors (OR 8.0), and fully slatted floors (OR 18.8). Slip or skid marks in the dunging area (OR 1.5), pigs observed slipping during the examination of the pen (OR 1.3) and wet floors (OR 3.6) were also associated with an increased risk of Bursitis. The results indicate that Bursitis is a common condition of growing pigs and that the associated risk factors for Bursitis were a lack of bedding in the lying area, presence of voids and pen conditions which increased the likelihood of injury.
Amy L. Kilbride - One of the best experts on this subject based on the ideXlab platform.
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a cross sectional study of the prevalence and associated risk factors for capped hock and the associations with Bursitis in weaner grower and finisher pigs from 93 commercial farms in england
Preventive Veterinary Medicine, 2008Co-Authors: Amy L. Kilbride, Claire E Gillman, Pete Ossent, L E GreenAbstract:The prevalence of capped hock in 5601 post-weaning pigs from 93 pig farms in England was 17.2%. The prevalence increased with age. Once adjusted for age, the lowest prevalence of capped hock was observed in pigs kept on soil floors (usually covered with deep straw bedding). There was no significant increase in the risk of capped hock in pigs kept on solid concrete floors with deep straw bedding. However, pigs kept on solid concrete with some, or the entire pen, sparsely bedded and pigs kept on partially or fully slatted floors had an approximately threefold increased risk of capped hock. This did not vary significantly between these four floor types. This was in contrast to the associated risks for Bursitis in the same pigs, where as the floor went from highly resilient (straw and solid floors) to hard and perforated (fully slatted) the risk of Bursitis increased in a similar way to a dose response. No other variables that were measured were associated with a change in risk for capped hock, while observation of pigs slipping or slip marks and wet, dirty and worn pens were also associated risks for Bursitis. These results indicate that capped hock and Bursitis are both affected by exposure to floors, but in different ways. The prevalence of capped hock was associated only with floor hardness, with deep straw protecting the pigs, while Bursitis was associated with both changes in bedding depth (hardness), floor material (soil versus concrete) and floor construction (solid versus slatted floors) and in factors associated with locomotion (slipping and slip marks). These results indicate that the aetiology of capped hock and Bursitis might differ.
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a cross sectional study of the prevalence and associated risk factors for Bursitis in weaner grower and finisher pigs from 93 commercial farms in england
Preventive Veterinary Medicine, 2008Co-Authors: Claire E Gillman, Amy L. Kilbride, Pete Ossent, L E GreenAbstract:A cross-sectional study of 93 farms in England was carried out to estimate the prevalence and associated risk factors for Bursitis. A total of 6250 pigs aged 6-22 weeks were examined for presence and severity of Bursitis. Details of pen construction, pen quality and farm management were recorded including floor type, presence of bedding, condition of the floor and floor materials. The prevalence of Bursitis was 41.2% and increased with each week of age (OR 1.1). Two-level logistic regression models were developed with the outcome as the proportion of pigs affected with Bursitis in a pen. Pigs kept on soil floors with straw bedding were used as the reference level. In comparison with these soil floors, Bursitis increased on concrete floors where the bedding was deep throughout (OR 4.6), deep in part (OR 3.7), and sparse throughout (OR 9.0), part slatted floors (OR 8.0), and fully slatted floors (OR 18.8). Slip or skid marks in the dunging area (OR 1.5), pigs observed slipping during the examination of the pen (OR 1.3) and wet floors (OR 3.6) were also associated with an increased risk of Bursitis. The results indicate that Bursitis is a common condition of growing pigs and that the associated risk factors for Bursitis were a lack of bedding in the lying area, presence of voids and pen conditions which increased the likelihood of injury.
Fabrizio Cantini - One of the best experts on this subject based on the ideXlab platform.
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cervical interspinous Bursitis in active polymyalgia rheumatica
Annals of the Rheumatic Diseases, 2008Co-Authors: Carlo Salvarani, Libero Barozzi, Luigi Boiardi, Nicolo Pipitone, Gianluigi Bajocchi, Pierluigi Macchioni, Massimo Valentino, Fabrizio Cantini, Laura Niccoli, Mariagrazia CatanosoAbstract:Objective: To evaluate the inflammatory involvement of cervical interspinous bursae in patients with polymyalgia rheumatica (PMR) using magnetic resonance imaging (MRI). Methods: Twelve consecutive, untreated new patients with PMR were investigated. Five patients with fibromyalgia, 2 patients with cervical osteoarthritis and 6 patients with spondyloarthritis with neck pain served as controls. MRI of the cervical spine was performed in all 12 PMR case-patients and in 13 control-patients. Two of the 4 PMR patients with pelvic girdle pain also had MRI of the lumbar spine. Results: MRI evidence of interspinous cervical Bursitis was found in all patients with PMR, and in 3 patients with fibromyalgia, in 2 with psoriatic spondylitis and 1 with cervical osteoarthritis. A moderate to marked (grade >2 on a semiquantitative 0-3 scale) cervical Bursitis occurred significantly more frequently in patients with PMR than in control-patients (83.3% compared with 30.7%, p=0.015). In all patients and controls with cervical Bursitis the involvement was found at the C5-C7 cervical interspaces. MRI of the lumbar spine showed lumbar interspinous Bursitis at the L3-L5 lumbar interspaces in the 2 patients with PMR and pelvic girdle pain examined. Conclusions: Cervical interspinous Bursitis is a likely basis for discomfort in the neck of patients with PMR. The prominent inflammatory involvement of cervical bursae supports the hypothesis that PMR is a disorder of prominent involvement of extra-articular synovial structures.
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inflammatory changes of hip synovial structures in polymyalgia rheumatica
Clinical and Experimental Rheumatology, 2005Co-Authors: Fabrizio Cantini, Luigi Boiardi, Laura Niccoli, Carlotta Nannini, Angela Padula, Ignazio Olivieri, Carlo SalvaraniAbstract:OBJECTIVE: To investigate the hip inflammatory lesions and to evaluate the accuracy of clinical examination compared to magnetic resonance imaging (MRI) in patients with polymyalgia rheumatica (PMR) with pelvic girdle symptoms. Secondary end-point was to evaluate the sensitivity and specificity of ultrasonography (US) compared to MRI in the assessment of hip lesions. METHODS: Case-control study of 20 consecutive PMR patients and 40 controls with different rheumatic conditions. Both groups were clinically assessed for the presence of hip synovitis, trochanteric, iliopsoas and ischiogluteal Bursitis. Hip MRI was performed in all case-patients and in 10 controls. Both groups were examined by US. An additional group of 10 healthy controls was examined by hip US. RESULTS: Both MRI and US detected trochanteric Bursitis in 100% of PMR patients, bilateral in 18/20 (90%), and in 12/40 (30%) controls (p < 0.001). Hip synovitis was detected in 17/20 (85%) by MRI and in 9/20 (45%) by US (p < 0.02) in case-patients and in 18/40 (45%) controls. In PMR, MRI and US showed iliopsoas Bursitis in 10/20 (50%) and 6/20 (30%) and ischiogluteal Bursitis in 5/20 (25%) and 4/20 (20%) with no differences compared to controls. Clinical examination showed a good accuracy for hip synovitis, trochanteric and ischiogluteal Bursitis, while it overestimated the presence of iliopsoas Bursitis. US was less sensitive than MRI for the detection of hip synovitis and iliopsoas Bursitis (53% and 60%). CONCLUSION: Trochanteric Bursitis represents the most frequent hip lesion in PMR. A careful physical examination allows to detect all inflammatory lesions excluding iliopsoas Bursitis. US is less sensitive than MRI in the assessment of hip synovitis and iliopsoas Bursitis.
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shoulder ultrasonography in the diagnosis of polymyalgia rheumatica a case control study
The Journal of Rheumatology, 2001Co-Authors: Fabrizio Cantini, Carlo Salvarani, Luigi Boiardi, Laura Niccoli, Angela Padula, Ignazio Olivieri, Luigi Macchioni, Giovanni Ciancio, Mariano Mastrorosato, Fabrizio RubiniAbstract:OBJECTIVE: Magnetic resonance imaging (MRI) showed that subacromial/subdeltoid Bursitis is the most frequent shoulder lesion in polymyalgia rheumatica (PMR). We evaluated whether shoulder ultrasonography (US) was as effective as MRI in the detection of this lesion and assessed the sensitivity and specificity of bilateral subacromial/subdeltoid Bursitis in the diagnosis of PMR. METHODS: A case-control study of 57 consecutive case patients with untreated PMR and 114 controls seen over a 6 month period in 3 secondary referral rheumatology centers. Control patients consisted of the next 2 consecutive patients with bilateral shoulder aching and stiffness observed after the case patient. In all case and control patients the glenohumeral joint space, bursae, and long head biceps tendon were assessed by bilateral shoulder US. The first 24 case patients were also examined by bilateral shoulder MRI. RESULTS: US showed subacromial/subdeltoid Bursitis in 55/57 (96%) patients with PMR and in 25/114 (22%) controls (p < 0.001). The lesion was bilateral in 53/55 (96%) case patients and in 1/25 (4%) controls (p < 0.001). The frequency of glenohumeral joint synovitis and biceps tenosynovitis did not differ significantly between case patients and controls. In 100% of case patients MRI showed subacromial/subdeltoid Bursitis confirming US findings. The sonographic evidence of bilateral Bursitis had a sensitivity of 92.9%, specificity of 99. 1%, and positive predictive value of 98. 1% for the diagnosis of PMR. CONCLUSION: US and MRI were equally effective in confirming bilateral subacromial and subdeltoid Bursitis in PMR. This finding, in view of its high sensitivity and specificity, could be used as a new diagnostic criterion for PMR.
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retrocalcaneal Bursitis in spondyloarthropathy assessment by ultrasonography and magnetic resonance imaging
The Journal of Rheumatology, 1998Co-Authors: Ignazio Olivieri, Carlo Salvarani, Libero Barozzi, Fabrizio Cantini, Angela Padula, M De Matteis, A Pierro, Pietro PavlicaAbstract:Objective. To establish by magnetic resonance imaging (MRI) and ultrasonography (US) the frequency of retrocalcaneal bursa involvement in Achilles enthesitis of spondyloarthropathy (SpA) and to compare the results of the 2 examinations. Methods. Nineteen Achilles tendons with severe enthesitis and 9 normal tendons of 14 patients meeting the Amor criteria for SpA were examined by MRI and US. Results. Both MRI and US showed a significant increase in the mean Achilles tendon thickness in the pathologic legs compared to the normal legs both at the superior calcaneal surface and 3 cm above. MRI showed retrocalcaneal Bursitis in 14 (73.7%) of 19 pathologic legs and superficial Bursitis in 2 (10.5%). US showed fluid collection only in 7 of 14 retrocalcaneal bursae positive on MRI, and failed to show fluid in the 2 superficial bursae involved. Using MRI as the gold standard, US showed 50% sensitivity and 100% specificity for retrocalcaneal bursa involvement and lacked sensitivity for superficial Bursitis. Conclusion. Achilles tendon involvement in SpA is not only a disease of the enthesis but also of the adjacent bursae.
