An Atypical Case of Vasculitis: When ‘Occult’ 18FDG-PET Scan Findings Create a Classification Dilemma

  • Elena Lopez-Francos Internal Medicine Department, Epicura Hospital, Baudour, Belgium
  • Sammy Place Internal Medicine Department, Epicura Hospital, Baudour, Belgium
  • Daphnee Delplace Dermatology Department, Epicura Hospital, Baudour, Belgium
  • Frédéric Vandergheynst Internal Medicine Department, CHU Erasme, Université Libre de Bruxelles, Brussels, Belgium

Keywords

Polyarteritis nodosa, polymyalgia rheumatica, giant cell arteritis (GCA), PET scan

Abstract

We describe a 66-year old patient with a recurrent ulcer on her right ankle. Biopsy revealed medium-vessel vasculitis consistent with cutaneous polyarteritis nodosa. There were no signs or symptoms suggestive of systemic vasculitis, but a 18FDG-PET scan showed areas of increased uptake around the large arteries and the pelvic and shoulder girdles. These findings suggested polymyalgia rheumatica in the setting of large-vessel vasculitis. This case thus supports the statement from the Chapel-Hill consensus conference that classification of systemic vasculitis by vessel size is based on the vessels predominantly involved, but vessels of other sizes may also be affected.

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  • Published: 2019-12-23

    Issue: Vol 7 No 1 (view)

    Section: Articles

    How to cite:
    1.
    Lopez-Francos E, Place S, Delplace D, Vandergheynst F. An Atypical Case of Vasculitis: When ‘Occult’ 18FDG-PET Scan Findings Create a Classification Dilemma. EJCRIM [Internet]. 2019Dec.23 [cited 2020Sep.24];7(1). Available from: https://ejcrim.com/index.php/EJCRIM/article/view/1301