The following symptoms and complaints may indicate polymyalgia rheumatica (PMR):
- Girdling myalgia (muscle pain), symmetrically occurring, primarily affecting:
- Shoulder girdle/shoulder pain (70-95%).
- Neck and/or pelvic girdle (50-90%), bilateral (50-70%).
- Pressure painfulness
- Stiffness of the muscles, especially long-lasting morning stiffness (> 45 min).
- Weakness of the musculature
- General symptoms (fever, anorexia (loss of appetite), weakness and/or weight losst: average 6 kg) (40%).
- Peripheral manifestations:
- Bilateral (bilateral) bursitis (bursitis) subdeltoid (between the joint capsule of the shoulder joint and the deltoid muscle)/subacromialis (under the coracoid process (acromion) of the shoulder blade)
- Non-osseous, asymmetric mono-, oligo-, or polyarthritis/joint inflammation (esp. knee and wrist joints)
- Carpal tunnel syndrome (KTS) – compression syndrome (narrowing syndrome) of the median nerve in the region of the carpal canal.
- Back of the hand edema / water retention on the back of the hand (possibly also foot back edema).
- Tenosynovitis (tendonitis) of the knee, hand or finger joints.
Polymyalgia rheumatica is associated with giant cell arteritis in 20-50% of cases.
The following symptoms and complaints may indicate giant cell arteritis (RZA):
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The following symptoms and complaints may indicate giant cell arteritis (RZA):
- due toInvolvement of the cranial vessels (approximately 70% of patients):
- Severe constant headache (60-90% of those affected); hemifacial or bilateral, especially bitemporal (in the temporal region; tension-type headache) – the initial symptom in 48% of cases; usually responds poorly to analgesics (pain medications)
- Pain when chewing (chewing pain; Claudicatio masticatoria [pathognomonic symptom / characteristic of the disease]: chewing claudication; due toischemia (reduced blood flow) of the masticatory muscles), tongue pain, swallowing claudication.
- Hypersensitivity of the scalp (“scalp tenderness”) eg when combing hair.
- Eye involvement (in 70% of patients).
- Eye pain
- Diplopia (double vision, double images), due to muscle, cranial nerve, or brainstem involvement
- Visual disturbances, e.g., amaurosis fugax (transient blindness; regression of blindness within minutes).
- Sensitive temporal arteries (temporal artery).
- Pressurization, nodules in the area of the temporal arteries, possibly even pulselessness of the same.
- Cerebral ischemia (due to inflammatory involvement of the vertebral, basilar or carotid supply area), in 3-4% of cases.
- due toInvolvement of large vessels (aorta and aortic branches):
- Arm claudication – weakness/pain of one arm due to aortic arch syndrome (inflammatory involvement of the aorta); blood pressure side difference; in up to 15% of cases.
- Wg. Polymyalgia rheumatica (RZA is associated with polymyalgia rheumatica in more than 50% of cases):Myalgia (muscle pain), emphasized proximallyStiffness in the neck, shoulder and pelvic girdle.
- Polyneuropathy – occurs in about a quarter of those affected.
- Depression
The following general symptoms may occur wg systemic inflammation:
- Fever
- Night sweats (night sweats)
- Fatigue
- Anorexia (loss of appetite)
- Weight loss
- Anemia (anemia)
- due toInvolvement of the cranial vessels (approximately 70% of patients):