[Diagnostics and treatment of polymyalgia rheumatica]

Area of Science:

• Rheumatology
• Immunology
• Geriatric Medicine

Background:

• Polymyalgia rheumatica (PMR) is the most prevalent autoimmune inflammatory condition affecting individuals over 70.
• Characterized by bilateral shoulder and hip pain and stiffness, often impacting daily activities.
• PMR shares symptoms with other conditions, such as Giant Cell Arteritis (GCA) and elderly-onset rheumatoid arthritis, complicating diagnosis.

Purpose of the Study:

• To provide a comprehensive overview of Polymyalgia Rheumatica (PMR).
• To discuss diagnostic challenges and current treatment strategies for PMR.
• To highlight the association between PMR and Giant Cell Arteritis (GCA).

Main Methods:

• Review of clinical presentation and diagnostic criteria for PMR.
• Discussion of laboratory findings, including elevated C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
• Exploration of diagnostic imaging modalities such as ultrasonography and MRI.

Main Results:

• PMR typically affects individuals around 73 years of age, presenting with shoulder, neck, and hip pain.
• Elevated CRP and ESR levels are observed in over 90% of patients, though not specific.
• Imaging techniques like ultrasonography and MRI can support the diagnostic process.

Conclusions:

• Accurate diagnosis of PMR is crucial, especially differentiating it from mimics like GCA.
• Glucocorticoids are the mainstay of treatment, with a typical duration of 2-3 years.
• Methotrexate may be considered as an adjunct therapy in specific cases.