Polymyalgia Rheumatica in 21st Century
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease of elderly, characterised by pain and morning stiffness of the shoulder and pelvic girdle. Although the ethiopathogenesis of PMR is unknown, environmental and genetic factors are suspected. Despite the progress in imaging techniques achieved in recent years, there is no speific diagnostic test and the diagnosis is generally based on clinical features. The steroids are the main therapy for PRM. Thus, the dramatic response to steroid therapy has been used as a diagnostic criterion. Howeer, there is lack of optimal intervention regarding initial dose, usage period and dose reduction. Moreover, relapses can be seen during the steroid therapy. Methotrexate can be used in case of unresponsiveness to steroids or aim to reduce daily steroid dose. The experiences about using biologic agents are increasing in recent years.
Keywords : Polymyalgia rheumatica, diagnostic criteria, imaging, treatment