Laboratory values | Polymyalgia rheumatica

Laboratory values

Polymyalgia is a disease that belongs to the group of vasculitides (diseases associated with vascular inflammation). The disease can cause an increase in the inflammatory values. These include the CRP value, the leukocyte count in the blood and the blood sedimentation rate.

However, polymyalgia rheumatica is not a disease that is diagnosed on the basis of laboratory values. Only the blood sedimentation rate plays a role in the diagnosis. A normal blood sedimentation rate does not exclude the presence of the disease.

Symptoms

The leading symptom is relatively severe pain in the muscles of the upper half of the body, i.e. parts such as the shoulder, neck and hips are affected. The symptoms appear relatively quickly with the onset of the disease. Typical for a rheumatic disease is that the pain usually occurs at night.

The pain is present at rest as well as under stress. In the morning there is often stiffness in the affected areas. The morning routine in the bathroom is therefore difficult for many patients.

The symptoms improve with increasing movement during the course of the day. Some patients also experience general symptoms of illness such as fever, loss of appetite, fatigue, lack of drive, weight loss and night sweats. Sometimes the disease can also be accompanied by severe depression. If headaches in the temple area and visual disturbances occur simultaneously, this indicates a parallel arteritis temporalis. The artery can often be palpated and seen in a thickened state.

Diagnosis

Polymyalgia rheumatica is mainly diagnosed by taking a blood sample. In the blood it can then be determined that certain inflammatory parameters (CRP and BSG values) are elevated. In some cases, the number of white blood cells (leukocytes) is also increased.

Even though the muscles are painfully affected in polymyalgia rheumatica, it is typical for the disease that the laboratory value of creatine kinase (CK), whose increase indicates damage to the muscles, is not elevated.With many rheumatic illnesses one can still prove a so-called rheumatism factor, this is however not the case with the Polymyalgia rheumatica. Besides the laboratory findings, the patient’s symptoms are also groundbreaking. A secured diagnosis for a Polymyalgia rheumatica is present, if at least four points are reached from the listed list with the following criteria Furthermore, a therapy trial can be started if there is a well-founded suspicion of a disease.

As a rule, therapy is carried out with so-called glucocorticoids, which also include cortisone. If the pain is improved by the administration of cortisone, the diagnosis is also confirmed. Furthermore, if there is a well-founded suspicion of a disease, a therapy trial can be started.

As a rule, therapy is carried out with so-called glucocorticoids, which also include cortisone. If the pain is improved by the administration of cortisone, the diagnosis is also confirmed.

• Morning stiffness longer than 45 minutes (2 points)
• Rheumatoid factor and/or anti-CCP antibodies are negative (2 points)
• Pain in the pelvic girdle area or limited mobility in the hip joint (1 point)
• Otherwise no other joint is painfully affected (1 point)
• Both shoulders show inflammatory changes detected by ultrasound (1 point)
• At least one shoulder and hip joint is affected by inflammation (1 point)