Abstract
Polymyalgia rheumatica is the most common inflammatory rheumatic disease of the elderly, and shares many pathogenetic and epidemiological features with giant cell arteritis. The typical symptoms are bilateral aching of the shoulder girdle, associated with morning stiffness. The neck and hip girdle may also be involved. The diagnosis of polymyalgia rheumatica is made primarily on clinical grounds. There is no single diagnostic test, but sets of diagnostic criteria have been suggested by several groups of investigators, based on the typical clinical presentation and laboratory evidence of acute-phase reaction. Other conditions that may mimic polymyalgia rheumatica must be excluded by appropriate testing and close monitoring of the disease course. Glucocorticoids at low doses (15–20 mg/day initially) are the mainstay of treatment.
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References
Nesher G. Giant cell arteritis and polymyalgia rheumatica. In: Ball GV and Bridges SL Jr. (Eds.) Vasculitis. 2002, Oxford University Press, Oxford, UK.
Moosig F, Czech N, Mehl C, et al. Correlation between 18-fluorodeoxyglucose accumulation in large vessels and serological markers of inflammation in polymyalgia rheumatica: A quantitative PET study. Ann Rheum Dis, 2004;63:870–3.
Chuang, T.Y., Hunder, G.G., Ilstrup, D.M. and Kurland, L.T. Polymyalgia rheumatica: A 10-year epidemiologic and clinical study. Ann Intern Med, 1982;97:672–80.
Salvarani, C., Cantini, F., Olivieri, I. et al. Proximal bursitis in active polymyalgia rheumatica. Ann Intern Med, 1997;39:1199–207.
Cantini F, Nicoli L, Mannini C, et al. Inflammatory changes of the hip synovial structures in polymyalgia rheumatica. Clin Exp Rheumatol 2005;23:462–8.
Hamrin, B. Polymyalgia arteritica. Acta Med Scand 1972;533 (Suppl.), 1–131.
Bird, H.A., Esselinckx, W., Dison, A.S.J., Mowat, A.G. and Wood, P.H.N. An evaluation of criteria for polymyalgia rheumatica. Ann Rheum Dis, 1979;38:434–9.
Jones, J.G. and Hazleman, B.L. Prognosis and management of polymyalgia rheumatica. Ann Rheum Dis, 1981;40:1–5.
Healey, L.A. Long-term follow-up of polymyalgia rheumatica: Evidence for synovitis. Semin Arthritis Rheum, 1984;13:322–8.
González-Gay, M.A., García-Porrua, C., Salvarani C, Olivieri I, and Hunder GG. Polymyalgia manifestations in different conditions mimicking polymyalgia rheumatica. Clin Exp Rheumatol, 2000;18:755–9.
Lange, U., Teichmann, J., Stracke, H., Bretzel, R.G. and Neeck, G. Elderly onset rheumatoid arthritis and polymyalgia rheumatica: Ultrasonographic study of the glenohumeral joints. Rheumatol Int, 1998;17:229–32.
Healey, L.A. Relation of giant cell arteritis to polymyalgia rheumatica. Bailliere’s Clin Rheumatol, 1991;5:371–8.
Schmidt, W.A and Gromnica-Ihle, E.J. Incidence of temporal arteritis in patients with polymyalgia rheumatica: A prospective study using color Doppler ultrasonography of the temporal arteries. Rheumatology, 2002;20:309–18.
Hunder, G.G. Giant cell arteritis in polymyalgia rheumatica. Am J Med, 1997;102:514–16.
Caporali R, Montecucco C, Epis O, Bobbio-Pallavicini F, Maio T, and Cimmino MA. Presenting features of polymyalgia rheumatica (PMR) and rheumatoid arthritis with PMR-like onset: A prospective study. Ann Rheum Dis, 2001;60:1021–4.
Gran, J.T. and Myklebust, G. The Incidence and clinical characteristics of peripheral arthritis in polymyalgia rheumatica and temporal arteritis: A prospective study of 231 cases. Rheumatology, 2000;39:283–7.
Pease CT, Haugeberg G, Morgan AW, Montague B, Hensor EM, and Bhakta BB. Diagnosing late-onset rheumatoid arthritis, polymyalgia rheumatica, and temporal arteritis in patients presenting with polymyalgic symptoms. A prospective longterm study. J Rheumatol, 2005;32:1043–6.
Lopez-Hoyos M, Ruis de Alegria C, Blanco R, et al. Clinical utility of anti-CCP antibodies in the differential diagnosis of elderly-onset rheumatoid arthritis and polymyalgia rheumatica. Rheumatology, 2004;43:655–7.
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© 2008 Humana Press, a part of Springer Science+Business Media, LLC
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Nesher, G. (2008). Polymyalgia Rheumatica. In: Shoenfeld, Y., Cervera, R., Gershwin, M.E. (eds) Diagnostic Criteria in Autoimmune Diseases. Humana Press. https://doi.org/10.1007/978-1-60327-285-8_14
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DOI: https://doi.org/10.1007/978-1-60327-285-8_14
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