Polymyalgia rheumatica (musculoskeletal manifestations)
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Musculoskeletal manifestations of polymyalgia rheumatica are the commonest presentation of polymyalgia rheumatica.
Polymyalgia rheumatica is the most common inflammatory rheumatic condition in older adults 1.
Patients typically present with 1:
shoulder or pelvic girdle aches lasting over 2 weeks
morning shoulder or pelvic girdle stiffness
Although usually not required ultrasound may commonly show 2:
Several characteristic areas of hypermetabolic activity are seen on FDG PET/CT which likely reflect bursitis, synovitis, or tenosynovitis. Characteristic locations of hypermetabolic activity include the shoulder joints, sternoclavicular joints, interspinous regions, hip joints, prepubic regions, ischial tuberosities, and knee joints 3,4. Smaller joints of the wrist and hand are less commonly affected 3.
Treatment and prognosis
Treatment is usually low dose corticosteroids which most patients respond well to 1.
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- 3. Yuan Li, Qian Wang, Yunshan Zhou. 18F-FDG PET/CT Used for the Diagnosis of Polymyalgia Rheumatica in Patients of Fever of Unknown Origin/Inflammatory of Unknown Origin. J Nucl Med. 2019;60(supplement 1):1068.
- 4. Rehak Z, Sprlakova-Pukova A, Kazda T, Fojtik Z, Vargova L, Nemec P. 18F-FDG PET/CT in Polymyalgia Rheumatica—a Pictorial Review. BJR. 2017;90(1076):20170198. doi:10.1259/bjr.20170198 - Pubmed