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Polymyalgia rheumatica: 125 years of progress?
Patrick J Rooney1, Jennifer Rooney2, Geza Balint3
1Professor of Medicine, Department of Clinical Skills, St George's University, Grenada prooney@sgu.edu.
Scottish Medical Journal
|September 10, 2014
Summary
Polymyalgia rheumatica diagnosis and management have seen little progress in 125 years. Clinical acumen remains key, with no objective tests or improved treatments beyond corticosteroids.
Area of Science:
- Rheumatology
- Internal Medicine
Background:
- Polymyalgia rheumatica (PMR) is a distinct clinical condition primarily affecting the elderly.
- Despite extensive research, diagnostic and therapeutic advancements for PMR have been limited.
Purpose of the Study:
- To review literature on polymyalgia rheumatica (PMR) to assess clinical care progress over 125 years.
- To evaluate diagnostic and management advancements in PMR, considering its relationship with giant cell arteritis.
Main Methods:
- Literature search of Medline and PubMed using terms 'polymyalgia rheumatica', 'giant cell arteritis', and 'temporal arteritis'.
- Focus on studies treating PMR and giant cell arteritis as separate entities.
- Selection biased towards PMR as a distinct clinical diagnosis, relying on clinical acumen.
Main Results:
- Advances in clinical imaging and 60 years of research have minimally improved accurate disease definition for PMR.
- Clinical management of PMR has seen little change since the introduction of corticosteroids in the 1950s.
- The relationship between PMR and giant cell arteritis remains unclear.
Conclusions:
- Polymyalgia rheumatica (PMR) diagnosis remains predominantly clinical, lacking objective laboratory or imaging support.
- Objective diagnostic methods for PMR are needed to advance understanding of its etiology and optimize treatment.
- Effective prevention of PMR symptoms while minimizing corticosteroid side effects remains a challenge.
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