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Der Internist

, Volume 50, Issue 1, pp 51–60 | Cite as

Polymyalgia rheumatica

  • C. Duftner
  • C. Dejaco
  • M. SchirmerEmail author
CME Weiterbildung • Zertifizierte Fortbildung

Zusammenfassung

Die Polymyalgia rheumatica (PMR) ist eine häufige, chronisch entzündlich-rheumatische Erkrankung unklarer Ätiologie, die typischerweise Patienten ab dem 50. Lebensjahr betrifft. Neben der klinischen Diagnostik unterstützen moderne bildgebende Verfahren, wie die Sonographie und die Magnetresonanztomographie mit Nachweis einer bilateralen Bursitis subdeltoidea bzw. subacromialis, Tenosynovitis der Bizepssehnen und/oder Synovitis der Schultergelenke, die korrekte Diagnosestellung auch in klinisch schwierigen Fällen. Kortikosteroide sind die Medikamente der Wahl in der Behandlung der PMR, führen jedoch bei mehr als 50% der behandelten Patienten zu Nebenwirkungen. Ob Immunsuppressiva, wie Methotrexat oder Tumornekrosefaktor-α-Inhibitoren in der Behandlung der PMR effektiv sind, ist derzeit nicht geklärt.

Schlüsselwörter

Differenzialdiagnose Sonographie Magnetresonanztomographie Therapie Kortikosteroide 

Polymyalgia rheumatica

Abstract

Polymyalgia rheumatica (PMR) is a common chronic inflammatory rheumatic disease with unknown aetiology, affecting predominately people of middle age and older. Besides clinical symptoms and diagnostics, imaging techniques including sonography and magnetic resonance imaging may provide evidence of typical inflammatory lesions with bilateral bursitis subdeltoidea or subacromialis, tenosynovitis of the biceps tendon sheath and/or synovitis of the shoulder joints and thus may support the diagnosis of this disease in difficult cases. Corticosteroids are the cornerstone of treatment of PMR, but adverse events because of chronic corticosteroid use are observed in more than 50% of treated patients. Whether immunosuppressants, such as methotrexate and tumour necrosis factor-α inhibitors are effective in the therapy of PMR has still not yet been clarified.

Keywords

Differential diagnosis Ultrasound Magnetic resonance imaging Treatment Corticosteroids 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  1. 1.Abteilung für Innere Medizin, Krankenhaus der ElisabethinenKlagenfurtÖsterreich

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