polymyalgia rheumatica

Polymyalgia Rheumatica

Definition

Polymyalgia rheumatica is a syndrome that causes pain and stiffness in the hips and shoulders of people over the age of 50.

Description

Although the major characteristics of this condition are just pain and stiffness, there are reasons to believe it is more than just old-fashioned rheumatism. Patients are commonly so afflicted that their muscles atrophy from disuse. A similar complaint of such weakness is also seen in serious muscle diseases. Moreover, some patients develop arthritis or a disease called giant cell arteritis or temporal arteritis.

Causes and symptoms

This condition may arise as often as once in every 2,000 people. Rarely does it affect people under 50 years old. The average age is 70; women are afflicted twice as often as men. Along with the pain and stiffness of larger muscles, headache may add to the discomfort. The scalp is often tender. Pain is usually worse at night. There may be fever and weight loss before the full disease appears. Patients complain that stiffness is worse in the morning and returns if they have been inactive for any period of time, a condition called gelling. Sometimes the stiffness is severe enough that it causes frozen shoulder.

Diagnosis

Symptoms are usually present for over a month by the time patients seek medical attention. A mild anemia is often is often present. One blood test, called an erythrocyte sedimentation rate, is very high, much more so than in most other diseases. The most important issue in evaluating polymyalgia rheumatica is to check for giant cell arteritis. Giant cell arteritis can lead to blindness if lift untreated.

Treatment

Polymyalgia rheumatica responds dramatically to cortisone-like drugs in modest doses. In fact, one part of confirming the diagnosis is to observe the response to this treatment. It may also respond to nonsteroidal anti-inflammatory drugs (NSAIDs). Temporal arteritis is also treated with cortisone, but in higher doses.

Prognosis

The disease often remits after a while, with no further treatment required.

Key terms

Anemia — A condition in which the blood lacks enough red blood cells (hemoglobin).Atrophy — Wasting away of a body part.Frozen shoulder — A shoulder that becomes scarred and cannot move.Giant cell arteritis — Also called temporal arteritis. A condition which causes the inflammation of temporal arteries. It can cause blindness when the inflammation effects the ophthalmic artery.NSAIDs — Non-steroidal anti-inflammatory drugs like aspirin, ibuprofen, and naproxen.Syndrome — A collection of abnormalities that occur often enough to suggest they have a common cause.

Resources

Books

Griggs, Robert C. "Episodic Muscle Spasms, Cramps, andWeakness." In Harrison's Principles of Internal Medicine, edited by Anthony S. Fauci, et al. New York: McGraw-Hill, 1997.

pol·y·my·al·gi·a rheu·ma·ti·ca

a syndrome within the group of collagen diseases different from spondylarthritis or from humeral scapular periarthritis by the presence of an elevated sedimentation rate; much commoner in women than in men.

polymyalgia rheumatica

Polymyalgia Internal medicine A condition characterized by an abrupt onset of myalgia and arthralgia of the neck and proximal 'girdle' muscles, most prominent in the morning and after rest; systemic Sx are vague–aching of ≥ 30 mins, affecting 2+ major joints, in descending order, shoulder, hips and thighs, or neck/torso Pt profile > age 70; ♀:♂, 2:1 Clinical Pain exacerbated by movement, fatigue, malaise, weight loss, depression, low-grade fever Lab ↑ ESR, anemia of chronic disease, mild ↑ LFTs, ↑ WBCs, ↑ Igs, ↑ acute phase reactants Management NSAIDs, aspirin; if brutal, corticosteroids; PR may be associated with other inflammatory conditions, giant cell/temporal arteritis, connective tissue disorders, CA

polymyalgia rheumatica

An uncommon disease of the elderly causing muscle pain and stiffness in the hips, thighs, shoulders, and neck. The cause is uncertain. A striking feature is the difficulty in getting out of bed in the mornings. Corticosteroid drugs are effective. Some affected people also suffer from TEMPORAL ARTERITIS (giant cell arteritis) and may require urgent treatment with corticosteroid drugs to prevent blindness. About half the patients with giant cell arteritis suffer from polymyalgia rheumatica.

单词	polymyalgia rheumatica
释义	polymyalgia rheumatica Translations EncyclopediaSeePMR polymyalgia rheumatica Polymyalgia Rheumatica Definition Polymyalgia rheumatica is a syndrome that causes pain and stiffness in the hips and shoulders of people over the age of 50. Description Although the major characteristics of this condition are just pain and stiffness, there are reasons to believe it is more than just old-fashioned rheumatism. Patients are commonly so afflicted that their muscles atrophy from disuse. A similar complaint of such weakness is also seen in serious muscle diseases. Moreover, some patients develop arthritis or a disease called giant cell arteritis or temporal arteritis. Causes and symptoms This condition may arise as often as once in every 2,000 people. Rarely does it affect people under 50 years old. The average age is 70; women are afflicted twice as often as men. Along with the pain and stiffness of larger muscles, headache may add to the discomfort. The scalp is often tender. Pain is usually worse at night. There may be fever and weight loss before the full disease appears. Patients complain that stiffness is worse in the morning and returns if they have been inactive for any period of time, a condition called gelling. Sometimes the stiffness is severe enough that it causes frozen shoulder. Diagnosis Symptoms are usually present for over a month by the time patients seek medical attention. A mild anemia is often is often present. One blood test, called an erythrocyte sedimentation rate, is very high, much more so than in most other diseases. The most important issue in evaluating polymyalgia rheumatica is to check for giant cell arteritis. Giant cell arteritis can lead to blindness if lift untreated. Treatment Polymyalgia rheumatica responds dramatically to cortisone-like drugs in modest doses. In fact, one part of confirming the diagnosis is to observe the response to this treatment. It may also respond to nonsteroidal anti-inflammatory drugs (NSAIDs). Temporal arteritis is also treated with cortisone, but in higher doses. Prognosis The disease often remits after a while, with no further treatment required. Key terms Anemia — A condition in which the blood lacks enough red blood cells (hemoglobin).Atrophy — Wasting away of a body part.Frozen shoulder — A shoulder that becomes scarred and cannot move.Giant cell arteritis — Also called temporal arteritis. A condition which causes the inflammation of temporal arteries. It can cause blindness when the inflammation effects the ophthalmic artery.NSAIDs — Non-steroidal anti-inflammatory drugs like aspirin, ibuprofen, and naproxen.Syndrome — A collection of abnormalities that occur often enough to suggest they have a common cause. Resources Books Griggs, Robert C. "Episodic Muscle Spasms, Cramps, andWeakness." In Harrison's Principles of Internal Medicine, edited by Anthony S. Fauci, et al. New York: McGraw-Hill, 1997. pol·y·my·al·gi·a rheu·ma·ti·ca a syndrome within the group of collagen diseases different from spondylarthritis or from humeral scapular periarthritis by the presence of an elevated sedimentation rate; much commoner in women than in men. polymyalgia rheumatica Polymyalgia Internal medicine A condition characterized by an abrupt onset of myalgia and arthralgia of the neck and proximal 'girdle' muscles, most prominent in the morning and after rest; systemic Sx are vague–aching of ≥ 30 mins, affecting 2+ major joints, in descending order, shoulder, hips and thighs, or neck/torso Pt profile > age 70; ♀:♂, 2:1 Clinical Pain exacerbated by movement, fatigue, malaise, weight loss, depression, low-grade fever Lab ↑ ESR, anemia of chronic disease, mild ↑ LFTs, ↑ WBCs, ↑ Igs, ↑ acute phase reactants Management NSAIDs, aspirin; if brutal, corticosteroids; PR may be associated with other inflammatory conditions, giant cell/temporal arteritis, connective tissue disorders, CA polymyalgia rheumatica An uncommon disease of the elderly causing muscle pain and stiffness in the hips, thighs, shoulders, and neck. The cause is uncertain. A striking feature is the difficulty in getting out of bed in the mornings. Corticosteroid drugs are effective. Some affected people also suffer from TEMPORAL ARTERITIS (giant cell arteritis) and may require urgent treatment with corticosteroid drugs to prevent blindness. About half the patients with giant cell arteritis suffer from polymyalgia rheumatica. AcronymsSeepatient medical record
随便看	tuina tui na an mo tuinhuis tui ná tuip tuipae tuir tuis tuism tuit tuition tuition aid data systems tuitional tuition and fees deduction tuition and fees, room and board tuitionary tuition assistance tuition assistance program tuition fee tuition fees tuition fees insurance tuition form tuition forms tuition loan tuition opportunity program for students