title: [Diagnostics and treatment of polymyalgia rheumatica].
abstract: Polymyalgia rheumatica (PMR) is the most common autoimmune inflammatory disease in older persons with an average age of onset of 73 years. Typical symptoms include acute or subacute bilateral shoulder pain with severe stiffness and often neck and bilateral hip pain. Giant cell arteritis (GCA) occurs in approximately 20 % of cases and up to two thirds of patients with GCA have symptoms of PMR. There are many disease which mimic PMR, elderly onset rheumatoid arthritis is frequently misdiagnosed as PMR. Although there are no specific laboratory tests, C‑reactive protein and erythrocyte sedimentation rates are elevated in over 90 % of patients. The diagnosis may be aided by imaging, especially ultrasonography and magnetic resonance imaging (MRI). Treatment currently consists of glucocorticoids at an initial dose of 12.5-25 mg prednisone equivalent daily. Treatment duration is typically 2‑3 years but may be longer. Under certain conditions low-dose methotrexate can be used as adjuvant therapy.
authors.affiliation: Klinische Abteilung für Rheumatologie, Medizinische Universität Graz, Graz, Österreich.
authors.forename: C
authors.initials: C
authors.lastname: Dejaco
authors.affiliation: Division of Rheumatology and Division of Epidemiology, Departments of Internal Medicine and Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Matteson
authors.affiliation: Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische Immunologie, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. frank.buttgereit@charite.de.
authors.forename: F
authors.initials: F
authors.lastname: Buttgereit
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000628:therapy; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D019317:Evidence-Based Medicine; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D011111:Polymyalgia Rheumatica / Q000175:diagnosis* / Q000628:therapy*; D011241:Prednisone / Q000008:administration & dosage*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011241:Prednisone; D008727:Methotrexate
keywords: Arthritis; Autoimmune diseases; Epidemiology; Monitoring; Treatment