[Polymyalgia rheumatica - frequent, but often overlooked].

Area of Science:

• Rheumatology
• Internal Medicine
• Geriatrics

Background:

• Musculoskeletal complaints affecting the shoulder and pelvic girdle are common in older adults, often attributed to degenerative changes.
• Polymyalgia rheumatica (PMR) is a significant inflammatory differential diagnosis, second only to rheumatoid arthritis.
• PMR presents with acute weakness, pain, and morning stiffness in the neck, shoulders, and pelvis, potentially with B-symptoms.

Purpose of the Study:

• To highlight the importance of considering Polymyalgia Rheumatica (PMR) in patients with shoulder and pelvic girdle pain.
• To outline the diagnostic approach, including differential diagnoses and potential complications like giant cell arteritis.
• To describe current treatment strategies for PMR.

Main Methods:

• Clinical examination focusing on differential diagnoses and complications.
• Laboratory testing for inflammatory markers.
• Arthrosonography to identify specific inflammatory signs such as tenosynovitis, bursitis, or joint effusion.

Main Results:

• Elevated inflammatory markers are observed in nearly all PMR cases.
• Arthrosonography commonly reveals tenosynovitis, bursitis, or hip joint effusion.
• PMR requires careful differentiation from other musculoskeletal and systemic conditions.

Conclusions:

• Polymyalgia rheumatica is a crucial inflammatory condition to rule out in elderly patients with shoulder and pelvic girdle pain.
• Diagnostic workup involves clinical assessment, inflammatory marker evaluation, and imaging.
• Initial treatment with steroids is effective, with advanced therapies available for refractory cases.