Polymyalgia rheumatica history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History and Symptoms
There are a wide range of symptoms that indicate if a person has polymyalgia rheumatica. The symptoms include pain and stiffness in the muscles, usually in the neck, shoulders, and hips. The pain is moderate to severe, and may inhibit the activity of the person. These symptoms usually occur in the morning, or after sleeping. The muscle strength is intact, though it may be limited by pain. There may be synovitis in knees, wrists, sterno-clavicular (SC) joints, hips/shoulders and distal extremity swelling (tenosynovitis).
Fatigue and lack of appetite are also signs of polymyalgia rheumatica. Lack of appetite could lead to unintentional weight loss. Anemia is another sign of polymyalgia rheumatica. An overall feeling of illness and a slight fever are also signs of this disorder.
Studies have shown that about 15% of people who are diagnosed with polymyalgia rheumatica also have temporal arteritis, and about 50% of people with temporal arteritis have polymyalgia rheumatica. Some symptoms of temporal arteritis include severe headaches, scalp tenderness, jaw or facial soreness, distorted vision or aching in the limbs caused by decreased blood flow, and fatigue.
Relation to Giant Cell Arteritis (GCA)
- 25% of patients with GCA have PMR as presenting symptom
- 40-60% of patients with GCA have PMR during disease course
- 10-15% of patients with PMR have GCA by temporal artery (TA) biopsy
| Symptoms GCA | Signs GCA | ||
| Headache | 68% | Decreased TA pulsations | 46% |
| Jaw claudication | 45% | Fever | 42% |
| Transient visual symptoms | 16% | Tenderness over temporal artery | 27% |
| Fixed visual loss | 14% | Nodular or swollen scalp arteries | 23% |
| Dysphagia | 8% | Large artery bruits | 21% |
| Tongue claudication | 6% | Ophthalmoscopic abnormalities | 18% |
| Visual loss | 14% |