Current diagnosis and treatment of polymyalgia rheumatica |
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| Institution: | 1. Department of Radiology, West China Hospital, Sichuan University, No 37, Guoxuexiang, 610041 Chengdu, China;2. Department of Orthopaedic, West China Hospital, Sichuan University, No 37, Guoxuexiang, 610041 Chengdu, China;1. Department of Oncology, University of Turin, Orbassano, Italy;2. Division of Medical Oncology, S.G. Moscati Hospital, Avellino, Italy;3. Clinical Cancer Center “Giovanni Paolo II”, Bari, Italy;4. Medical Oncology Unit, University Hospital of Parma, Parma, Italy;5. Medical Oncology Unit, Regina Elena Cancer Institute, Rome, Italy;6. Medical Oncology Unit, San Gerardo Hospital, Monza, Italy;7. Oncology Department, Radiation Therapy Unit, Careggi Hospital, Florence, Italy;8. Medical Oncology Unit, San Giovanni Addolorata Hospital, Rome, Italy;9. Medical Oncology Unit, E. Morelli Hospital, Sondalo, Italy;10. Medical Oncology Unit, Santa Maria degli Angeli Hospital, Pordenone, Italy;11. Medical Oncology Unit, D. Camberlingo Francavilla Fontana Hospital, Brindisi, Italy;12. Medical Oncology Unit, Saronno Hospital, Saronno, Italy;13. Oncology and Hematology Unit, ULSS 13, Mirano, Italy;14. Department of Clinical and Biological Science, University of Turin, Orbassano, Italy;1. Medical Research Center of Shandong Provincial Qianfoshan Hospital, Shandong University, Jingshi road 16766, Jinan, Shandong, 250014 P.R. China;2. Rheumatology Department of Shandong Provincial Hospital, Jinan, Shandong, 250014 P.R. China;1. Division of Rheumatology, Department of Internal Medicine, Kocaeli University Faculty of Medicine, Umuttepe Kampüsü, 41380 Kocaeli, Turkey;2. Department of Dermatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey;3. Department of Pathology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey;1. Service de rhumatologie, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France;2. Centre de référence en infections ostéoarticulaires complexes du Grand Ouest (CRIOGO), CHU de Rennes, 35043 Rennes cedex, France |
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| Abstract: | The diagnostic and therapeutic strategies for polymyalgia rheumatica (PMR) have changed substantially in recent years. Rather than a single disease entity, PMR has emerged as a syndrome produced by a variety of conditions. The diagnostic criteria that have been used for several decades are inadequate. These facts support a new and broader pathological concept, polymyalgic syndrome, and a standardized diagnostic and therapeutic approach designed to rule out diseases with misleading presentations and to identify the limited number of patients with polymyalgic syndrome who have PMR. Criteria for both polymyalgic syndrome and PMR were developed recently but remain to be validated. These criteria are discussed, as well as the suggested diagnostic approach and treatment strategy. In contrast, studies on pathophysiological models, inflammatory mechanisms, and genetic factors are not considered herein, as they were conducted in heterogeneous populations of patients who did not meet the new criteria. Current data indicate that polymyalgic syndrome is a mode of onset of inflammatory joint disease in individuals older than 50 years of age and not (in most cases) a disease entity. |
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| Keywords: | Polymyalgia rheumatica Polymyalgic syndrome Diagnostic criteria Glucocorticoid therapy PMR-DAS |
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