Polymyalgia rheumatica history and symptoms: Difference between revisions
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==Overview== | ==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]].<ref name="pmid22388996">{{cite journal| author=Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C et al.| title=2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. | journal=Ann Rheum Dis | year= 2012 | volume= 71 | issue= 4 | pages= 484-92 | pmid=22388996 | doi=10.1136/annrheumdis-2011-200329 | pmc=PMC3298664 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22388996 }} </ref> There is an association between PMR and [[giant cell arteritis]] which can present with one or more of the following symptoms [[headaches]], scalp tenderness, [[jaw claudication]], [[fever]], or distorted vision.<ref name="pmid7598301">{{cite journal| author=Salvarani C, Gabriel SE, O'Fallon WM, Hunder GG| title=The incidence of giant cell arteritis in Olmsted County, Minnesota: apparent fluctuations in a cyclic pattern. | journal=Ann Intern Med | year= 1995 | volume= 123 | issue= 3 | pages= 192-4 | pmid=7598301 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7598301 }} </ref><ref name="pmid7880191">{{cite journal| author=Salvarani C, Gabriel SE, O'Fallon WM, Hunder GG| title=Epidemiology of polymyalgia rheumatica in Olmsted County, Minnesota, 1970-1991. | journal=Arthritis Rheum | year= 1995 | volume= 38 | issue= 3 | pages= 369-73 | pmid=7880191 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7880191 }} </ref><ref name="pmid1629827">{{cite journal| author=Franzén P, Sutinen S, von Knorring J| title=Giant cell arteritis and polymyalgia rheumatica in a region of Finland: an epidemiologic, clinical and pathologic study, 1984-1988. | journal=J Rheumatol | year= 1992 | volume= 19 | issue= 2 | pages= 273-6 | pmid=1629827 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1629827 }} </ref> | 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]].<ref name="pmid22388996">{{cite journal| author=Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C et al.| title=2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. | journal=Ann Rheum Dis | year= 2012 | volume= 71 | issue= 4 | pages= 484-92 | pmid=22388996 | doi=10.1136/annrheumdis-2011-200329 | pmc=PMC3298664 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22388996 }} </ref> 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.<ref name="pmid7598301">{{cite journal| author=Salvarani C, Gabriel SE, O'Fallon WM, Hunder GG| title=The incidence of giant cell arteritis in Olmsted County, Minnesota: apparent fluctuations in a cyclic pattern. | journal=Ann Intern Med | year= 1995 | volume= 123 | issue= 3 | pages= 192-4 | pmid=7598301 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7598301 }} </ref><ref name="pmid7880191">{{cite journal| author=Salvarani C, Gabriel SE, O'Fallon WM, Hunder GG| title=Epidemiology of polymyalgia rheumatica in Olmsted County, Minnesota, 1970-1991. | journal=Arthritis Rheum | year= 1995 | volume= 38 | issue= 3 | pages= 369-73 | pmid=7880191 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7880191 }} </ref><ref name="pmid1629827">{{cite journal| author=Franzén P, Sutinen S, von Knorring J| title=Giant cell arteritis and polymyalgia rheumatica in a region of Finland: an epidemiologic, clinical and pathologic study, 1984-1988. | journal=J Rheumatol | year= 1992 | volume= 19 | issue= 2 | pages= 273-6 | pmid=1629827 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1629827 }} </ref> | ||
== History and Symptoms == | == History and Symptoms == | ||
* PMR is typically characterized by 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.<ref name="pmid22388996">{{cite journal| author=Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C et al.| title=2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. | journal=Ann Rheum Dis | year= 2012 | volume= 71 | issue= 4 | pages= 484-92 | pmid=22388996 | doi=10.1136/annrheumdis-2011-200329 | pmc=PMC3298664 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22388996 }} </ref> The symptoms last for more than 30 days and involve the body parts symmetrically.<ref name="pmid12140303">{{cite journal| author=Salvarani C, Cantini F, Boiardi L, Hunder GG| title=Polymyalgia rheumatica and giant-cell arteritis. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 4 | pages= 261-71 | pmid=12140303 | doi=10.1056/NEJMra011913 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12140303 }} </ref> The morning stiffness lasts for at approximately 30 | * PMR is typically characterized by 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.<ref name="pmid22388996">{{cite journal| author=Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C et al.| title=2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. | journal=Ann Rheum Dis | year= 2012 | volume= 71 | issue= 4 | pages= 484-92 | pmid=22388996 | doi=10.1136/annrheumdis-2011-200329 | pmc=PMC3298664 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22388996 }} </ref> The symptoms last for more than 30 days and involve the body parts symmetrically.<ref name="pmid12140303">{{cite journal| author=Salvarani C, Cantini F, Boiardi L, Hunder GG| title=Polymyalgia rheumatica and giant-cell arteritis. | journal=N Engl J Med | year= 2002 | volume= 347 | issue= 4 | pages= 261-71 | pmid=12140303 | doi=10.1056/NEJMra011913 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12140303 }} </ref> The morning stiffness lasts for at 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. | ||
* In some patients, there is involvement of the distal parts of the body that can manifest as:<ref name="pmid22388996">{{cite journal| author=Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C et al.| title=2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. | journal=Ann Rheum Dis | year= 2012 | volume= 71 | issue= 4 | pages= 484-92 | pmid=22388996 | doi=10.1136/annrheumdis-2011-200329 | pmc=PMC3298664 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22388996 }} </ref> | * In some patients, there is involvement of the distal parts of the body that can manifest as:<ref name="pmid22388996">{{cite journal| author=Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C et al.| title=2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. | journal=Ann Rheum Dis | year= 2012 | volume= 71 | issue= 4 | pages= 484-92 | pmid=22388996 | doi=10.1136/annrheumdis-2011-200329 | pmc=PMC3298664 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22388996 }} </ref> | ||
| Line 13: | Line 13: | ||
** [[Pitting edema]] | ** [[Pitting edema]] | ||
** Hand [[swelling]] | ** Hand [[swelling]] | ||
** [[ | ** [[Carpal tunnel syndrome]] | ||
* Constitutional symptoms can also be present:<ref name="pmid22388996">{{cite journal| author=Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C et al.| title=2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. | journal=Ann Rheum Dis | year= 2012 | volume= 71 | issue= 4 | pages= 484-92 | pmid=22388996 | doi=10.1136/annrheumdis-2011-200329 | pmc=PMC3298664 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22388996 }} </ref> | * Constitutional symptoms can also be present:<ref name="pmid22388996">{{cite journal| author=Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C et al.| title=2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. | journal=Ann Rheum Dis | year= 2012 | volume= 71 | issue= 4 | pages= 484-92 | pmid=22388996 | doi=10.1136/annrheumdis-2011-200329 | pmc=PMC3298664 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22388996 }} </ref> | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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.[1] 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.[2][3][4]
History and Symptoms
- PMR is typically characterized by 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.[5] The morning stiffness lasts for at 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.
- 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]
- There is an association between PMR and giant cell arteritis. While 40 to 60% of patients with giant cell arteritis have PMR, 16 to 21% of patients with PMR develop giant cell arteritis.[2][3][4] Some symptoms of temporal arteritis include severe headaches, scalp tenderness, jaw claudication, fever, distorted vision or aching in the limbs caused by decreased blood flow, and fatigue.
References
- ↑ 1.0 1.1 1.2 1.3 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.
- ↑ 2.0 2.1 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.
- ↑ 3.0 3.1 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.
- ↑ 4.0 4.1 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.
- ↑ 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.