Positron emission tomography in the diagnosis of eosinophilic fasciitis

Cheriet, Sarah; Chastan, Mathieu; Lévesque, H.; Marie, I.

doi:10.1093/qjmed/hcq218

Cited by 16 publications

(7 citation statements)

References 5 publications

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“…L'éosinophilie tissulaire n'est pas impérative pour retenir le diagnostic [1,4,[6][7][8][9] et elle semble corrélée à l'éosi-nophilie sanguine [9]. L'imagerie joue un rôle de plus en plus important dans le diagnostic et le suivi de la fasciite à éosi-nophiles [11][12][13]. L'IRM permet de mettre en évidence une fasciite, une myosite associée, et guide la biopsie en ciblant la zone de prélèvement optimale [11,12].…”

Section: Discussionunclassified

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Trismus secondaire à une fasciite à éosinophiles : un cas et revue de la littérature

Cloitre

Poursac

Catros

et al. 2014

Med Buccale Chir Buccale

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Résumé -Introduction :La fasciite à éosinophiles, ou maladie de Shulman, est une connectivite sclérosante localisée, rare et d'étiologie inconnue. Les atteintes faciales sont exceptionnelles. Observation : Le cas rapporté décrit un trismus sévère dans le cadre d'une fasciite à éosinophiles. Discussion et revue de la littérature : Le diagnostic de fasciite à éosinophiles doit être évoqué devant un trismus associé à des myalgies. Le diagnostic de cette pathologie permet une prise en charge adaptée, mais des séquelles restent possibles.Abstract -Trismus consecutive to eosinophilic fasciitis: case report and review of the literature.

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Section: Discussionunclassified

“…L'IRM permet de mettre en évidence une fasciite, une myosite associée, et guide la biopsie en ciblant la zone de prélèvement optimale [11,12]. Le TEP scan [13] et les ultrasons [14] ont eux aussi été récemment proposés. Des études prospectives sont nécessaires pour déterminer la sensibilité et la spécificité de ces examens radiologiques.…”

Section: Discussionunclassified

Trismus secondaire à une fasciite à éosinophiles : un cas et revue de la littérature

Cloitre

Poursac

Catros

et al. 2014

Med Buccale Chir Buccale

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“…Case reports confirm the added value of MRI for both diagnostic purposes [137] and for the assessment of the fasciitis [39, 138]. In addition, ultrasound [41, 42] and positron emission tomography (PET) [43–45] have also been reported to be helpful for similar purposes. In conclusion, MRI may be considered for the assessment of EF.…”

Section: Assessment Of Musculoskeletal Involvementmentioning

confidence: 91%

“…The presence of thickened dermal collagen fibers may reflect the presence of concomitant superficial morphea [14, 15]. More recently, magnetic resonance imaging (MRI) [38–40], ultrasound [41, 42], and positron emission tomography (PET) [43–45] have been reported to be helpful in establishing the diagnosis by decreasing the likelihood of sampling errors for deep biopsies or by visualizing the fasciitis.…”

Section: Histopathologymentioning

confidence: 99%

Morphea and Eosinophilic Fasciitis: An Update

et al. 2017

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Morphea, also known as localized scleroderma, encompasses a group of idiopathic sclerotic skin diseases. The spectrum ranges from relatively mild phenotypes, which generally cause few problems besides local discomfort and visible disfigurement, to subtypes with severe complications such as joint contractures and limb length discrepancies. Eosinophilic fasciitis (EF, Shulman syndrome) is often regarded as belonging to the severe end of the morphea spectrum. The exact driving mechanisms behind morphea and EF pathogenesis remain to be elucidated. However, extensive extracellular matrix formation and autoimmune dysfunction are thought to be key pathogenic processes. Likewise, these processes are considered essential in systemic sclerosis (SSc) pathogenesis. In addition, similarities in clinical presentation between morphea and SSc have led to many theories about their relatedness. Importantly, morphea may be differentiated from SSc based on absence of sclerodactyly, Raynaud’s phenomenon, and nailfold capillary changes. The diagnosis of morphea is often based on characteristic clinical findings. Histopathological evaluation of skin biopsies and laboratory tests are not necessary in the majority of morphea cases. However, full-thickness skin biopsies, containing fascia and muscle tissue, are required for the diagnosis of EF. Monitoring of disease activity and damage, especially of subcutaneous involvement, is one of the most challenging aspects of morphea care. Therefore, data harmonization is crucial for optimizing standard care and for comparability of study results. Recently, the localized scleroderma cutaneous assessment tool (LoSCAT) has been developed and validated for morphea. The LoSCAT is currently the most widely reported outcome measure for morphea. Care providers should take disease subtype, degree of activity, depth of involvement, and quality-of-life impairments into account when initiating treatment. In most patients with circumscribed superficial subtypes, treatment with topical therapies suffices. In more widespread disease, UVA1 phototherapy or systemic treatment with methotrexate (MTX), with or without a systemic corticosteroid combination, should be initiated. Disappointingly, few alternatives for MTX have been described and additional research is still needed to optimize treatment for these debilitating conditions. In this review, we present a state-of-the-art flow chart that guides care providers in the treatment of morphea and EF.

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“…Une hyperfixation des régions incriminées a été rapportée en TEP au FDG [63] mais l'absence de couplage à une imagerie en coupe ne permettait pas de différencier les fascias des muscles .…”

Section: Capillaroscopieunclassified