101. Pathogenesis, Diagnosis and Management of Polymyalgia Rheumatica
- Author
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G. Girasole, Andrea Giusti, Christian Dejaco, Gerolamo Bianchi, and Dario Camellino
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Giant Cell Arteritis ,Diagnosis, Differential ,Polymyalgia rheumatica ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,immune system diseases ,Pathognomonic ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,skin and connective tissue diseases ,Adverse effect ,Glucocorticoids ,Aged ,Biological Products ,business.industry ,medicine.disease ,Dermatology ,Giant cell arteritis ,Polymyalgia Rheumatica ,Antirheumatic Agents ,Rheumatoid arthritis ,Methotrexate ,Geriatrics and Gerontology ,Vasculitis ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Polymyalgia rheumatica is an inflammatory rheumatic disease of the elderly characterised by pain and stiffness in the neck and pelvic girdle, and is the second most common inflammatory rheumatic condition in this age group, after rheumatoid arthritis. Polymyalgia rheumatica can occur independently or in association with giant cell arteritis, which is the most common form of primary vasculitis. The diagnosis of polymyalgia rheumatica is usually based on clinical presentation and increase of inflammatory markers. There are no pathognomonic findings that can confirm the diagnosis. However, different imaging techniques, especially ultrasonography, can assist in the identification of polymyalgia rheumatica. Glucocorticoids are the cornerstone of the treatment of polymyalgia rheumatica, but they might be associated with different adverse events. A subgroup of patients presents with a refractory disease course and, in these cases, adding methotrexate as a steroid-sparing agent could be useful. In this review, we summarise the latest findings regarding the pathogenesis, diagnosis and management of polymyalgia rheumatica and try to highlight the possible pitfalls, especially in elderly patients.
- Published
- 2019
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