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Polymyalgia Rheumatica

Polymyalgia Rheumatica

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Pathology

The syndrome of pain and stiffness, usually in the neck, shoulders and hips, is associated with HLA-DR4 and Giant Cell Arteritis.

Aetiology

The specific cause of this syndrome remains unknown, however, it is thought that environmental factors such as a virus may lead to an immune response in individuals that are genetically predisposed.

Symptoms

  • Joint stiffness
  • Malaise
  • Fatigue
  • Difficulty completing daily life activities
  • Morning stiffness for more than one hour
  • Muscle stiffness after prolonged inactivity

Signs

Symmetrical joint stiffness, low grade fever, and weight loss are among the visible signs of this syndrome.

Investigations

The most sensitive test to diagnose PMR is a raised ESR (erythrocyte sedimentation rate). Other blood tests such as FBC (full blood count), ANA (antinuclear antibody), RF (rheumatoid factor), and CK (creatinine kinase) are often normal.

Treatment

Medical treatment includes low dose corticosteroids.

Complications

Complications of the syndrome may include the development of Giant Cell Arteritis.

Prognosis

With prompt diagnosis and adequate therapy, patients of this syndrome have an excellent prognosis. On average, the disease lasts for three years.

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