Polymyalgia rheumatica history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
Polymyalgia rheumatica (PMR) is typically characterized by symmetrical pain and morning stiffness in the proximal joints and limbs, including the neck, the shoulder girdle, the pelvic girdle, the lower back, and the thighs. In some patients, there is involvement of the distal parts of the body such as peripheral synovitis or arthritis. Constitutional symptoms can also be present, and they include fever, fatigue, loss of appetite, and weight loss. There is an association between PMR and giant cell arteritis which can present with one or more of the following symptoms that include headaches, scalp tenderness, jaw claudication, fever, or distorted vision.
History and Symptoms
- Common symptoms of PMR include:
- Pain and morning stiffness in the proximal joints and limbs, including the neck, the shoulder girdle, the pelvic girdle, the lower back, and the thighs.[1] The symptoms last for more than 30 days and involve the body parts symmetrically.[2] The morning stiffness lasts for approximately 30 to 45 minutes. The pain is moderate to severe, and may interfere with sleep and daily activities such as getting dressed in the morning or getting up from a chair. These symptoms usually occur in the morning, or after sleeping. The muscle strength is intact, though it may be limited by pain. Shown below is an image depicting the typical location of the pain and stiffness:
- In some patients, there is involvement of the distal parts of the body that can manifest as:[1]
- Peripheral synovitis or arthritis
- Pitting edema
- Hand swelling
- Carpal tunnel syndrome
- Constitutional symptoms can also be present:[1]
- Symptoms of temporal arteritis include:[3][4][5]
- Severe headaches
- scalp tenderness
- Jaw claudication
- Fever
- Distorted vision
- Aching in the limbs caused by decreased blood flow
- Fatigue
References
- ↑ 1.0 1.1 1.2 Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C; et al. (2012). "2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative". Ann Rheum Dis. 71 (4): 484–92. doi:10.1136/annrheumdis-2011-200329. PMC 3298664. PMID 22388996.
- ↑ Salvarani C, Cantini F, Boiardi L, Hunder GG (2002). "Polymyalgia rheumatica and giant-cell arteritis". N Engl J Med. 347 (4): 261–71. doi:10.1056/NEJMra011913. PMID 12140303.
- ↑ Salvarani C, Gabriel SE, O'Fallon WM, Hunder GG (1995). "The incidence of giant cell arteritis in Olmsted County, Minnesota: apparent fluctuations in a cyclic pattern". Ann Intern Med. 123 (3): 192–4. PMID 7598301.
- ↑ Salvarani C, Gabriel SE, O'Fallon WM, Hunder GG (1995). "Epidemiology of polymyalgia rheumatica in Olmsted County, Minnesota, 1970-1991". Arthritis Rheum. 38 (3): 369–73. PMID 7880191.
- ↑ Franzén P, Sutinen S, von Knorring J (1992). "Giant cell arteritis and polymyalgia rheumatica in a region of Finland: an epidemiologic, clinical and pathologic study, 1984-1988". J Rheumatol. 19 (2): 273–6. PMID 1629827.