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[Polymyalgia rheumatica (arteritica)].

D Pongratz1

  • 1Friedrich-Baur-Institut der Medizinischen Fakultät an der Neurologischen Klinik und Poliklinik der LMU München. dieter.pongratz@fbs.med.uni-muenchen.de

MMW Fortschritte Der Medizin
|December 17, 2004
PubMed
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Polymyalgia rheumatica primarily affects individuals over 60. Diagnosis involves lab tests and potentially electromyography or biopsy, with treatment typically requiring a year of glucocorticoids.

Area of Science:

  • Rheumatology
  • Internal Medicine
  • Clinical Diagnosis

Context:

  • Polymyalgia rheumatica (PMR) is a common inflammatory condition predominantly affecting individuals over 60 years of age.
  • PMR diagnosis can be challenging due to overlapping symptoms with other rheumatic diseases.
  • A significant proportion of PMR patients (40-50%) also present with concomitant giant cell arteritis (GCA).

Purpose:

  • To outline the diagnostic criteria and laboratory parameters for polymyalgia rheumatica.
  • To discuss the differential diagnosis of PMR, including the role of electromyography and muscle biopsy.
  • To describe the standard treatment approach for PMR, emphasizing the duration and dosage adjustments of glucocorticoids, particularly in the presence of GCA.

Summary:

  • Polymyalgia rheumatica (PMR) is characterized by muscle pain and stiffness, primarily in older adults (>60 years).

Related Experiment Videos

  • Diagnostic workup includes inflammatory markers like erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), creatine kinase (CK), and autoantibodies.
  • When findings are equivocal, electromyography (EMG) and muscle biopsy aid in diagnosis. Concomitant giant cell arteritis (GCA) occurs in 40-50% of cases.
  • Treatment involves glucocorticoids for at least one year, with initial and tapering doses adjusted based on GCA presence.

    • Impact:

    • Improved diagnostic accuracy for polymyalgia rheumatica, reducing misdiagnosis and delayed treatment.
    • Enhanced understanding of the association between PMR and giant cell arteritis, guiding clinical management.
    • Provides a clear treatment guideline for polymyalgia rheumatica, emphasizing the importance and duration of glucocorticoid therapy.