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magnetic resonance imaging &#40;MRI&#41; is currently considered the ideal imaging modality for diagnosis EF&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> This technique is also useful for determining the optimal location of muscle biopsy and for follow-up purposes&#46; The ussefulness for the diagnosis of other imaging techniques&#44; such as &#91;<span class="elsevierStyleSup">18</span>F&#93; FDG-PET&#47;CT or ultrasonography&#44; is beginning to be explored&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3&#8211;5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We report a case of EF in a 72-year-old woman who presented with a 1-month history of fatigue&#44; weight loss&#44; and rapidly progressive induration of her lower limbs without any skin manifestations&#46; Laboratory tests showed an elevated erythrocyte sedimentation rate and hypereosinophilia&#46; &#91;<span class="elsevierStyleSup">18</span>F&#93; FDG-PET&#47;CT discarded an occult neoplasia and revealed a diffuse and symmetrical FDG uptake in the fasciae of the legs and thighs &#40;see <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A biopsy specimen from the right leg&#44; in which the FDG uptake was the strongest&#44; showed marked eosinophilic infiltration in the fascia&#44; but not in the muscle&#46; The clinical suspicion of EF was confirmed and the patient was treated successfully with corticosteroids and methotrexate&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The association of malignancy with certain rheumatic syndromes&#44; including FE was convincingly established&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1&#44;2</span></a> In those cases in which this possibility arises &#40;explosive onset in advanced age or EF poorly responsive to corticosteroid therapy&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> the realization of a PET&#8211;CT could be useful to rule out occult neoplasia and to reinforce the suspected diagnosis&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethics approval</span><p id="par0025" class="elsevierStylePara elsevierViewall">In accordance with the guidelines of our institutional ethics committee&#44; formal approval for this study was not required&#46; The local ethics committee agreed that the findings in this report were based on normal clinical practice and were therefore suitable for dissemination&#46; Informed consent of the patient was obtained&#44; and her clinical record and information were anonymized&#46; This study was conducted in accordance with the principles of the Declaration of Helsinki and the International Conference for Harmonization&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Data availability statement</span><p id="par0030" class="elsevierStylePara elsevierViewall">All relevant data are within the paper&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Ethical disclosures</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Protection of human and animal subjects</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Confidentiality of data</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Right to privacy and informed consent</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Funding</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors have no support or funding to report&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors have declared that no competing interests exists&#46;</p></span></span>"
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Images in Clinical Rheumatology
[18F] FDG PET/CT may be a useful adjunct in diagnosis of eosinophilic fasciitis
[18F] FDG PET/CT puede ser un complemento útil en el diagnóstico de fasciitis eosinofílica
Javier Narváeza,
Autor para correspondencia
fjnarvaez@bellvitgehospital.cat

Corresponding author.
, Pablo Juareza, Isabel Morales Ivorraa, Laura Rodriguez Belb, Jesus Rodriguez Morenoa, Montserrat Romeraa
a Department of Rheumatology, Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
b PET Unit, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitario de Bellvitge-IDIBELL, Barcelona, Spain
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magnetic resonance imaging &#40;MRI&#41; is currently considered the ideal imaging modality for diagnosis EF&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> This technique is also useful for determining the optimal location of muscle biopsy and for follow-up purposes&#46; The ussefulness for the diagnosis of other imaging techniques&#44; such as &#91;<span class="elsevierStyleSup">18</span>F&#93; FDG-PET&#47;CT or ultrasonography&#44; is beginning to be explored&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3&#8211;5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We report a case of EF in a 72-year-old woman who presented with a 1-month history of fatigue&#44; weight loss&#44; and rapidly progressive induration of her lower limbs without any skin manifestations&#46; Laboratory tests showed an elevated erythrocyte sedimentation rate and hypereosinophilia&#46; &#91;<span class="elsevierStyleSup">18</span>F&#93; FDG-PET&#47;CT discarded an occult neoplasia and revealed a diffuse and symmetrical FDG uptake in the fasciae of the legs and thighs &#40;see <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A biopsy specimen from the right leg&#44; in which the FDG uptake was the strongest&#44; showed marked eosinophilic infiltration in the fascia&#44; but not in the muscle&#46; The clinical suspicion of EF was confirmed and the patient was treated successfully with corticosteroids and methotrexate&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The association of malignancy with certain rheumatic syndromes&#44; including FE was convincingly established&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1&#44;2</span></a> In those cases in which this possibility arises &#40;explosive onset in advanced age or EF poorly responsive to corticosteroid therapy&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> the realization of a PET&#8211;CT could be useful to rule out occult neoplasia and to reinforce the suspected diagnosis&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethics approval</span><p id="par0025" class="elsevierStylePara elsevierViewall">In accordance with the guidelines of our institutional ethics committee&#44; formal approval for this study was not required&#46; The local ethics committee agreed that the findings in this report were based on normal clinical practice and were therefore suitable for dissemination&#46; Informed consent of the patient was obtained&#44; and her clinical record and information were anonymized&#46; This study was conducted in accordance with the principles of the Declaration of Helsinki and the International Conference for Harmonization&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Data availability statement</span><p id="par0030" class="elsevierStylePara elsevierViewall">All relevant data are within the paper&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Ethical disclosures</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Protection of human and animal subjects</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Confidentiality of data</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Right to privacy and informed consent</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Funding</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors have no support or funding to report&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflict of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors have declared that no competing interests exists&#46;</p></span></span>"
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