Keywords:
Education, Diagnostic procedure, Ultrasound, PET-CT, MR, Musculoskeletal system, Musculoskeletal joint, Inflammation
Authors:
R. Leao, L. C. Zattar-Ramos, E. L. Bizetto, M. F. Correa, M. B. Rodrigues, D. T. Amaral, C. Obara Kurimori, P. V. P. Helito, R. Y. Fernandes, H. P. Costa; Sao Paulo/BR
DOI:
10.1594/essr2016/P-0117
Background
- Introduction and epidemiology
Polymyalgia rheumatica (PMR) is an inflammatory disease that affects people over the age of 50.
The peak incidence occurs between ages 70 and 80 people over 50 years. Women are affected two to three times more often than men.
PMR cannot be considered a rare disease,
with an annual incidence of 52.5 – 68.3/100,000. On the other hand,
the lack of specific diagnostic lab tests and image findings often causes a delay in the diagnosis of PMR.
There is a close relation to giant cell arteritis (it occurs in about 50 % of patients with it).
Main symptoms: aching and morning stiffness in the shoulders,
hip girdle,
neck,
and torso
- Stiffness – morning stiffness,
which lasts at least 30 minutes.
- Pain – Shoulder,
hip and neck.
Pain is worse with movement and may interfere with sleep.
- Synovitis and bursitis: causes the discomfort and stiffness.
- Swelling and tenosynovitis – hands,
wrists,
ankles,
and feet.
- Tenosynovitis: can cause carpal tunnel syndrome (10%)
- Systemic signs and symptoms – including malaise,
fatigue,
depression,
anorexia,
weight loss,
and low-grade fever.
1.
High VHS and C-reactive protein levels.
2.
Serologic tests: All negative: antinuclear antibodies,
rheumatoid factor,
and cyclic citrullinated peptide antibodies