What is polymyalgia rheumatica (PMR)?
Polymyalgia rheumatica is an inflammatory condition affecting the hips and shoulders of people over the age of 50 years. PMR may cause sudden shoulder and/or hip pain, especially after or during rest from activity. It usually affects both sides of the body. It may also cause fever, fatigue, weight loss, depression, and night sweats.
What causes polymyalgia rheumatica (PMR)?
The cause of PMR is not very well understood. The inflammation from PMR is not due to infection, though various infections may need to be excluded before a diagnosis of PMR is made. In PMR, it appears the body’s immune system attacks itself, in some ways similar to rheumatoid arthritis.
How is polymyalgia rheumatica (PMR) diagnosed?
The diagnosis is first suspected by typical symptoms in an older patient. Blood tests may include complete blood count (CBC), sedimentation rate (ESR), and C-reactive protein. If needed, ultrasound may detect bursitis in the shoulder. PET/CT scan is also very sensitive and specific for PMR.
How does polymyalgia rheumatica (PMR) affect the eyes?
When PMR is associated with inflammation of the blood vessels, the eye can become affected. This closely-related blood vessel inflammation is called giant cell arteritis (also called cranial arteritis or temporal arteritis). Giant cell arteritis (GCA) causes symptoms similar to PMR with the addition of headache, neck stiffness, tenderness of the scalp, and cramping of the tongue or jaw when speaking or chewing. These symptoms indicate inflammation of the blood vessels of the head. Loss of vision may occur due to retinal artery occlusion or ischemic optic neuropathy. Early diagnosis is critical to begin treatment and limit the damage from blood vessel inflammation, which includes complications of brain stroke.
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