Small- to medium-sized arteritis diagnosed by F-18 FDG PET/CT: A case report

Rationale: Early diagnosis of arteritis is challenging due to nonspecific symptoms and often requires invasive procedures. This case illustrates the utility of F-18 FDG PET/CT as a noninvasive imaging modality for identifying inflammatory vascular diseases, thereby facilitating timely treatment and avoiding unnecessary interventions. Patient concerns: A 65-year-old man presented to the emergency department with a persistent fever and generalized muscle pain lasting for 3 weeks. Diagnoses: F-18 FDG PET/CT revealed linear and branching tree-like patterns of hypermetabolism in the arteries of both arms and thighs, leading to the diagnosis of arteritis. Interventions: Following the rheumatologist’s recommendation, intravenous prednisolone therapy was initiated. Outcomes: Shortly after starting prednisolone therapy, his fever subsided and muscle pain resolved. Lessons: This case highlights the valuable role of F-18 FDG PET/CT in diagnosing small- to medium-sized arteritis, providing a noninvasive approach that can help avoid unnecessary procedures and inappropriate use of antibiotics, while also enabling objective monitoring of treatment response.