Polymyalgia rheumatica

Polymyalgia rheumatica is a clinical syndrome characterized by pain and stiffness in the muscles of the shoulder girdle, pelvic girdle and neck muscles. The disease occurs in people over the age of 50, women are more often affected. Giant cell arteriitis occurs in 10–20% at the same time.

Etiopathogenesis
The etiopathogenesis of the disease is not fully understood. Age (with increasing incidence) and genetic factors play a role. Patients have a large number of IL-6- producing monocytes in their blood.

The clinical picture
The disease usually develops suddenly. It manifests itself in stiffness and pain in the muscles of the shoulder girdle, pelvic girdle and neck muscles. The pain is most intense in the morning. Pain limits the range of active movements. General symptoms include fatigue, subfebrile illness, weight loss, nausea, and nausea. Patients may appear severely ill.

Diagnosis
The diagnosis of the disease is usually by exclusion, as no specific test is available.


 * Laboratory findings - increased erythrocyte sedimentation, CRP, IL-6.
 * Imaging methods - if current giant cell arteriitis is suspected, PET / CT, for example, is suitable.

Differential diagnosis

 * Rheumatoid arthritis.
 * polymyozitida.
 * osteoarthrosis.
 * fibromyalgia.

Treatment
he disease is characterized by a good response to glucocorticoid therapy. Doses of 10-20 mg prednisone daily are usually given. We gradually reduce the dose of corticoids after the response is achieved. Some patients require prednisone for more than two years.

'''Prevention of osteoporosis should be considered with long-term administration of glucocorticoids. All patients should be prescribed vitamin D, calcium or bisphosphonates .'''

Related Articles

 * Treatment of inflammatory rheumatic diseases
 * Giant cell arteriitis