Differentiating Polymyalgia rheumatica from other diseases
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Polymyalgia rheumatica (PMR) must be differentiated from other conditions such as late onset rheumatoid arthritis, polymyositis, dermatomyositis, fibromyalgia, and remitting seronegative symmetrical synovitis with pitting edema.
Differentiating Polymyalgia Rheumatica from other Diseases
Polymyalgia rheumatica (PMR) must be differentiated from other conditions such as late onset rheumatoid arthritis, polymyositis, dermatomyositis, fibromyalgia, and remitting seronegative symmetrical synovitis with pitting edema.[1][2][3][4]
Differentiating polymyalgia rheumatica on the basis of fatigue and chronic pain
Disease | Differentiating signs and symptoms | Diagnostic findings |
---|---|---|
Polymyalgia rheumatica |
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Fibromyalgia |
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Rheumatoid arthritis |
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SLE |
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Chronic fatigue syndrome | Fatigue plus 4 of the following symptoms:
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Spondyloarthritis |
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Osteoarthritis |
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Hypothyroidism |
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Polymyositis and dermatomyositis |
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Neuropathy |
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Differentiating polymyalgia rheumatica from other causes of inflammatory myopathy
Organ system | Disease | Symptoms | History | Physical
Examination |
Diagnosis | ||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age of onset | Muscle weakness | Fever | Myalgia | Contractures | Gait abnormality | Neuropathy | Atrophy | Stiffness | Myoglobinuria | Other features | Laboratory Findings | Creatine Kinase | Muscle Biopsy | Electromyogram | |||||
Inflammatory/ Rheumatologic | Polymyalgia Rheumatica[5] | 50s | Diffuse | + | + | − | − | − | − | + | − |
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Dermatomyositis[6] | 40s−50s Can affect children |
Proximal | + | + | − | − | − | − | + | − |
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||||||
Polymyositis[7] | > 18 years | Proximal | + | + | − | − | − | − | + | − |
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Inclusion body myositis[8] | 50s | Proximal & distal |
− | − | − | − | − | − | − | − |
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Fibromyalgia[9] | 40−50s | Generalized | − | − | − | − | + | − | − | − |
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Organ system | Disease | Age of onset | Muscle weakness | Fever | Myalgia | Contractures | Gait abnormality | Neuropathy | Atrophy | Stiffness | Myoglobinuria | Other features | History | Physical
Examination |
Laboratory Findings | Creatine Kinase | Muscle Biopsy | Electromyogram |
References
- ↑ Pease CT, Haugeberg G, Montague B; et al. (2009). "Polymyalgia rheumatica can be distinguished from late onset rheumatoid arthritis at baseline: results of a 5-yr prospective study". Rheumatology (Oxford). 48 (2): 123–7. doi:10.1093/rheumatology/ken343. PMID 18980958. Unknown parameter
|month=
ignored (help) - ↑ Pease CT, Haugeberg G, Morgan AW, Montague B, Hensor EM, Bhakta BB (2005). "Diagnosing late onset rheumatoid arthritis, polymyalgia rheumatica, and temporal arteritis in patients presenting with polymyalgic symptoms. A prospective longterm evaluation". J. Rheumatol. 32 (6): 1043–6. PMID 15940765. Unknown parameter
|month=
ignored (help) - ↑ Sørensen CD, Hansen LH, Hørslev-Petersen K (2010). "[Myositis as differential diagnosis in polymyalgia rheumatica]". Ugeskr. Laeg. (in Danish). 172 (42): 2899–900. PMID 21040663. Unknown parameter
|month=
ignored (help) - ↑ Hopkinson ND, Shawe DJ, Gumpel JM (1991). "Polymyositis, not polymyalgia rheumatica". Ann. Rheum. Dis. 50 (5): 321–2. PMC 1004419. PMID 2042988. Unknown parameter
|month=
ignored (help) - ↑ Myklebust G, Gran JT (1996). "A prospective study of 287 patients with polymyalgia rheumatica and temporal arteritis: clinical and laboratory manifestations at onset of disease and at the time of diagnosis". Br J Rheumatol. 35 (11): 1161–8. PMID 8948307.
- ↑ Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.
- ↑ Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.
- ↑ Dalakas MC (1991). "Polymyositis, dermatomyositis and inclusion-body myositis". N Engl J Med. 325 (21): 1487–98. doi:10.1056/NEJM199111213252107. PMID 1658649.
- ↑ Ohara N, Katada S, Yamada T, Mezaki N, Suzuki H, Suzuki A, Hanyu O, Yoneoka Y, Kawachi I, Shimohata T, Kakita A, Nishizawa M, Sone H (2016). "Fibromyalgia in a Patient with Cushing's Disease Accompanied by Central Hypothyroidism". Intern. Med. 55 (21): 3185–3190. doi:10.2169/internalmedicine.55.5926. PMC 5140872. PMID 27803417.