Polymyalgia rheumatica (PMR) (synonyms: polymyalgic pain syndrome; polymyalgia; polymyalgia arteriitica; polymyalgia idiopathica; gr./lat. rheumatic multimuscle pain; ICD-10 M35.3: polymyalgia rheumatica) refers to an inflammatory rheumatic disease. It belongs to the group of vasculitides (inflammation of blood vessels).
Polymyalgia rheumatica can occur in the setting of giant cell arteritis (RZA; synonyms: Arteritis temporalis; Horton-Magath-Brown syndrome; cranial arteritis; Horton’s disease; Polymyalgia arteriitica; Polymyalgia arteriitica with giant cells; Polymyalgia rheumatica; Giant cell arteritis a.n.k. ; giant cell arteritis in polymyalgia rheumatica; giant cell arteritis in rheumatoid polymyalgia; ICD-10 M31.5: giant cell arteritis in polymyalgia rheumatica, M31.6: other giant cell arteritis) occur. This refers to inflammation of medium-sized and large arteries.
Some authors refer to polymyalgia rheumatica and giant cell arteritis (RZA) as a disease with different manifestations.
Sex ratio: males to females is 1: 3.
Peak incidence: the maximum incidence of polymyalgia rheumatica is beyond the age of 60 years (70 years of age with a spectrum from 50 to 90 years of age).The disease occurs almost exclusively in people above the age of 50 years.
The incidence (frequency of new cases) of polymyalgia rheumatica is approximately 50 cases per 100,000 population per year (in Northern Europe). The incidence of giant cell arteritis (RZA) in patients over 50 years of age is 3.5 per 100,000 population per year in Northern Europe. There is a marked north-south gradient in Europe. It is the most common systemic vasculitis (inflammation of blood vessels).
Course and prognosis: Polymyalgia rheumatica is associated with severe muscle pain, usually bilateral and usually most severe at night or in the morning. In about 40-50% of cases, arteritis temporalis (inflammation of the temporal artery) occurs simultaneously. With adequate pharmacotherapy (drug treatment), usually prednisolone (a synthetic glucocorticoid/hormone from the adrenal cortex), the symptoms improve in a few days. Polymyalgia rheumatica is often recurrent. Recurrence of the disease is common after reduction of glucocorticoids. The recurrence rate is approximately 30%. Maintenance therapy for at least one year may help to reduce the risk of recurrence.
Data on the duration of the disease vary between 1-3 years with frequent need for continuation of therapy for more than 5 years. The prognosis of polymyalgia rheumatica with regard to a complete cure is favorable.
Comorbidity (concomitant disease): polymyalgia rheumatica is associated with giant cell arteritis in 20-50% of cases.
