Diagnostic imaging for eosinophilic fasciitis: A systematic review

Eosinophilic Fasciitis Illustrated by 18F-FDG PET/CT

“…3 It is a rare pathology described by Shulman in 1974, characterized by symmetrical full-circumference sclerotic lesions with painful edema in all 4 limbs 1,3 with eosinophilia. [4][5][6] Edema is the most common initial symptom. 7 The criterion standard for confirming the diagnosis involves biopsy from the skin to the fascia.…”

“…MRI is typically used, but 18 F-FDG PET/CT also plays an important role in ruling out a paraneoplastic origin for these inflammatory symptoms. 4,6 Patients with this suspected indication may benefit specifically from PET/MRI studies. And also, that in view of the data provided by FDG PET/CT in future MRI may not be needed before biopsy 8 -if indeed so.…”

“…Imaging examinations aid in guiding the areas to be biopsied. MRI is typically used, but 18 F-FDG PET/CT also plays an important role in ruling out a paraneoplastic origin for these inflammatory symptoms 4,6. Patients with this suspected indication may benefit specifically from PET/MRI studies.…”

“…The etiology and the pathogenesis of Shulman fasciitis are not well understood, 1,2 but an autoimmune cause is probable 3 . It is a rare pathology described by Shulman in 1974, characterized by symmetrical full-circumference sclerotic lesions with painful edema in all 4 limbs 1,3 with eosinophilia 4–6 . Edema is the most common initial symptom 7 .…”

Role of ultrasound in guiding the biopsy site in eosinophilic fasciitis

“…Thus, US may help either in the diagnostic procedure to choose an area of disease activity and in the follow up to evaluate directly at patient bedside the therapeutic efficacy. [ 2 ] Among imaging methods, magnetic resonance imaging (MRI) is probably superior in detecting abnormalities of eosinophilic fasciitis, [ 3 ] but ultrasound is superior overall because it is cost-effective, has virtually no contraindications and is certainly much better accepted by patients, being able to use it from diagnosis to biopsy guide up to the entire follow-up.…”