A history of polymyalgia rheumatica: a narrative review

Area of Science:

• Rheumatology
• Internal Medicine

Background:

• Polymyalgia rheumatica (PMR) is a common inflammatory condition affecting individuals typically in their eighth decade.
• PMR presents with characteristic stiffness and pain in the shoulders, hips, and neck.
• PMR can co-occur with giant cell arteritis, suggesting shared underlying pathophysiological mechanisms.

Purpose of the Study:

• To review current understanding of Polymyalgia rheumatica (PMR) within a historical framework.
• To examine the evolution of classification criteria and their impact on clinical diagnosis.
• To highlight the importance of accurate diagnosis and collaborative care pathways for PMR.

Main Methods:

• This narrative review synthesizes existing literature on Polymyalgia rheumatica (PMR).
• The review traces the historical development of PMR nomenclature, classification criteria, and diagnostic approaches.
• It analyzes the relationship between PMR's musculoskeletal inflammation and vasculitic/synovitic diseases.

Main Results:

• The characteristic distribution of inflammation in PMR influences its description, classification, diagnosis, and treatment.
• Glucocorticoid response, while common in PMR, is not pathognomonic, complicating diagnosis.
• Effective management necessitates distinguishing PMR from other conditions and requires rheumatologist support for general practitioners.

Conclusions:

• Accurate and timely diagnosis of Polymyalgia rheumatica (PMR) is essential for appropriate management.
• Collaboration among healthcare professionals, including rheumatologists and general practitioners, is vital for improving diagnostic accuracy and treatment.
• Enhanced diagnostic pathways and multi-stakeholder collaboration are needed to ensure safe and effective care for PMR patients.