title: Polymyalgia rheumatica: 125 years of epidemiological progress?
abstract: OBJECTIVE
  On the 125th anniversary of the first recognised publication on polymyalgia rheumatica, a review of the literature was undertaken to assess what progress has been made from the point of view of the epidemiology of this disease and whether such studies have advanced our knowledge of its aetiopathogenesis and management.
  
  
  METHODS
  The authors searched Medline and PubMed using the search terms 'polymyalgia rheumatica', 'giant cell arteritis' and 'temporal arteritis'. As much as possible, efforts were made to focus on studies where polymyalgia and giant cell arteritis were treated as separate entities. The selection of articles was influenced by the authors' bias that polymyalgia rheumatica is a separate clinical condition from giant cell arteritis and that, as yet, the diagnosis is a clinical one.
  
  
  RESULTS
  This review has shown that, following the recognition of polymyalgia as a distinct clinical problem of the elderly, the results of a considerable amount of research efforts investigating the populations susceptible, the geographic distribution of these affected populations and the associated sociological and genetic elements that might contribute to its occurrence, polymyalgia rheumatica remains a difficult problem for the public health services of the developed world.
  
  
  CONCLUSIONS
  Polymyalgia rheumatica remains a clinical enigma and its relationship to giant cell arteritis is no clearer now than it has been for the past 125 years. Diagnosing this disease is still almost exclusively dependent on the clinical acumen of a patient's medical attendant. Until an objective method of identifying it clearly in the clinical setting is available, uncovering the aetiology is still unlikely. Until then, clear guidelines on the future incidence and prevalence of polymyalgia rheumatica and the public health problems of the disease and its management, especially in relation to the use of long term corticosteroids, will be difficult to provide.
authors.affiliation: Professor of Medicine, Department of Clinical Skills, St George's University, Grenada prooney@sgu.edu.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Rooney
authors.affiliation: Associate Professor of Medicine, Department of Clinical Skills, St George's University, Grenada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rooney
authors.affiliation: Consultant Rheumatologist, National Institute of Rheumatology and Physiotherapy, Hungary.
authors.forename: Geza
authors.initials: G
authors.lastname: Balint
authors.affiliation: Head of Department and Consultant Rheumatologist, 3rd Department of Rheumatology, National Institute of Rheumatology and Physiotherapy, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Balint
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004576:Electromyography; D013700:Giant Cell Arteritis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D005938:Glucocorticoids / Q000627:therapeutic use*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D011111:Polymyalgia Rheumatica / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D011379:Prognosis; D012606:Scotland / Q000453:epidemiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids
keywords: Polymyalgia rheumatica; Scandinavian and Viking influence; corticosteroid use; epidemiology; giant cell (temporal) arteritis