The "Ant-farm"-like Appearance of Restricted Lower Limb Vasculitis on Fluorodeoxyglucose-positron Emission Tomography

Shintaro Yamamoto; Tomoyuki Mukai; Shunichi Fujita; Yuka Koide; Yumika Ono; Masayuki Inubushi; Hirotake Nishimura; Asami Munekane; Yoshitaka Morita

doi:10.2169/internalmedicine.8016-21

CASE REPORTS

The "Ant-farm"-like Appearance of Restricted Lower Limb Vasculitis on Fluorodeoxyglucose-positron Emission Tomography

Shintaro Yamamoto, Tomoyuki Mukai, Shunichi Fujita, Yuka Koide, Yumika Ono, Masayuki Inubushi, Hirotake Nishimura, Asami Munekane, Yoshitaka Morita

Author information

Shintaro Yamamoto
Department of Rheumatology, Kawasaki Medical School, Japan
Tomoyuki Mukai
Department of Rheumatology, Kawasaki Medical School, Japan
Department of Immunology and Molecular Genetics, Kawasaki Medical School, Japan
Shunichi Fujita
Department of Rheumatology, Kawasaki Medical School, Japan
Yuka Koide
Department of Rheumatology, Kawasaki Medical School, Japan
Yumika Ono
Department of Nuclear Medicine, Kawasaki Medical School, Japan
Masayuki Inubushi
Department of Nuclear Medicine, Kawasaki Medical School, Japan
Hirotake Nishimura
Department of Pathology, Kawasaki Medical School, Japan
Asami Munekane
Department of Neurology, Kawasaki Medical School, Japan
Yoshitaka Morita
Department of Rheumatology, Kawasaki Medical School, Japan

Keywords: restricted lower limb vasculitis, muscle vasculitis, FDG-PET, fever, myalgia

JOURNAL OPEN ACCESS

2022 Volume 61 Issue 6 Pages 897-902

DOI https://doi.org/10.2169/internalmedicine.8016-21

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Abstract

Restricted lower limb vasculitis is a type of localized muscle vasculitis limited to the lower limbs. The usefulness of fluorodeoxyglucose-positron emission tomography (FDG-PET) for the diagnosis of this entity has not yet been reported. We herein report three patients with a fever and persistent lower limb pain. FDG-PET revealed linear and patchy FDG uptakes in their lower limbs. Combined with magnetic resonance imaging and histological findings, they were diagnosed with lower limb vasculitis. Linear and patchy FDG uptakes are considered to reflect the presence of muscle vasculitis. The characteristic "ant-farm"-like FDG-PET images can be a diagnostic clue for the currently overlooked vasculitis.

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