Epidemiology

  • Sex: ♀ > ♂ (3:1)
  • Age of onset: >70 years (rarely seen in patients < 50 years)

Tip

Women of advanced age are particularly prone to the disease.


Etiology

Association with giant cell arteritis (GCA): Approx. 10% of individuals with polymyalgia rheumatica also have GCA.


Pathophysiology


Clinical features

  • Systemic symptoms
    • Constitutional symptoms: fever, weight loss, night sweats
    • Fatigue and malaise
  • Musculoskeletal symptoms: primarily affects shoulders, neck, and pelvic girdle
    • New onset, symmetric pain that is worse at night
    • Morning stiffness (> 45 min)
    • Muscular atrophy and weakness: not directly caused by PMR but resulting from reduced activity due to pain and stiffness

Diagnostics

  • ↑ ESR, specifically > 50 mm/h
  • ↑ CRP
  • Normochromic anemia
  • Normal creatine kinase, negative rheumatoid factors, and no autoantibodies

Treatment