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[Polymyalgia rheumatica: diagnostic and therapeutic issues of an apparently straightforward disease.]

Ciro Manzo1, Dario Camellino2

  • 1Ambulatorio Interdistrettuale di Reumatologia e Servizio di Reumatologia Geriatrica, ex Ospedale "Mariano Lauro", Sant'Agnello (NA), Distretto Sanitario 59 ASL NA 3 Sud.

Recenti Progressi in Medicina
|June 24, 2017
PubMed

Insights

Polymyalgia rheumatica (PMR) is an inflammatory condition causing pain and stiffness, often affecting those over 50. Recognizing atypical presentations and differential diagnoses is key for accurate patient management.

Area of Science:

  • Rheumatology
  • Internal Medicine
  • Clinical Immunology

Background:

  • Polymyalgia rheumatica (PMR) is an inflammatory disorder affecting individuals over 50, causing girdle pain and stiffness.
  • PMR can overlap with giant cell arteritis (GCA) in 15-20% of cases.
  • While often straightforward, PMR diagnosis can be complicated by atypical presentations and mimics.

Purpose of the Study:

  • To review current knowledge on PMR clinical presentations.
  • To discuss differential diagnoses and the relationship between PMR and cancer.
  • To outline diagnostic clues for concomitant GCA, the role of ultrasonography, and treatment strategies.

Main Methods:

  • Literature synthesis of current knowledge on PMR.
  • Highlighting clinical "tips and tricks" for practical application.
  • Reviewing diagnostic criteria and imaging modalities.

Main Results:

  • PMR diagnosis requires awareness of diverse clinical scenarios.
  • Differential diagnoses include various rheumatologic and non-rheumatologic conditions.
  • Ultrasonography aids in early diagnosis and monitoring of PMR and GCA.

Conclusions:

  • Understanding PMR's varied presentations improves patient management.
  • Distinguishing PMR from mimics prevents misdiagnosis and overtreatment.
  • Early and accurate diagnosis of PMR and associated conditions like GCA is crucial.

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