Pronounced: Pol-ee-my-al-ja Roo-MAT-ic-ah
Polymyalgia rheumatica (PMR) is an inflammatory disorder. It results in muscle pain and stiffness in the body. The effects are most common in the shoulders, arms, hips, and thighs. About 15% of people with PMR will also develop giant cell arteritis (GCA). GCA results in inflammation and swelling of arteries. This occurs most often in the head. If not treated quickly, GCA may cause permanent blindness.
The exact cause is not known. Inflammatory conditions tend to be due to some kind of problem with the immune system. Some evidence suggests that certain viruses could be responsible for PMR and GCA. Genetic factors may also play a role as well.
Factors that may increase the risk for PMR and GCA include:
Symptoms of PMR often develop within two weeks. They may include:
Symptoms of GCA may include:
GCA needs to be treated immediately. This condition can lead to permanent blindness.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. There is no single test for PMR. To support the diagnosis and rule out other conditions, tests may include:
If you have PMR, your doctor may also consider the possibility of GCA. Evaluation for GCA includes:
Symptoms of PMR will disappear without treatment within several months to years. However, treatment leads to a dramatic improvement. It can occur within 24-48 hours. Treatment usually consists of:
GCA must be treated before blindness occurs. The blindness can not be reversed. Treatment is usually a high dose of corticosteroid medication for about one month. This is then tapered to a smaller dose for maintenance therapy. This step usually lasts for at least 1-2 years.
RESOURCES:
American College of Rheumatology
http://www.rheumatology.org/
Arthritis Foundation
http://www.arthritis.org/
CANADIAN RESOURCES:
The Arthritis Society
http://www.arthritis.ca/
Health Canada
http://www.hc-sc.gc.ca/
References:
American College of Rheumatology website. Available at: http://www.rheumatology.org/public/factsheets/pmr_new2.asp . Accessed March 25, 2007.
Eberhardt RT, Dhadly M. Giant cell arteritis: diagnosis, management, and cardiovascular implications. Cardiol Rev . 2007 Mar-Apr;15(2):55-61. Review.
National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/hi/topics/polymyalgia/ . Accessed March 25, 2007.
Soubrier M, Dubost JJ, Ristori JM. Polymyalgia rheumatica: diagnosis and treatment. Joint Bone Spine . 2006 Dec;73(6):599-605. Epub 2006 Oct 12. Review.
Last reviewed January 2009 by Jill D. Landis, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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