Rheumatic polymyalgia

Introduction Rheumatoid polymyalgia is common in the elderly, and it is a syndrome characterized by persistent neck, scapula, and pelvic girdle muscle stiffness. General characteristics of PMR insidious onset, there are low-heat, fatigue, burnout, weight loss and other systemic symptoms. Typical clinical manifestations are symmetrical neck, scapula or pelvic band with proximal muscle soreness, stiffness and discomfort. It can also be unilateral or limited to a certain group of muscle groups.

Cause

(1) Causes of the disease

The etiology and pathogenesis of PMR are still unclear. The cause may be multifactorial. Under the combination of internal factors and environment, the pathogenesis of the disease is considered to be related to HLA-DR4, suggesting that genetically susceptible infection may be the disease. One of the causes of the disease, in addition, the disease is almost all over 50 years old, suggesting that the disease is definitely related to age, the incidence of women is significantly higher than that of men, suggesting that this disease may also have a certain correlation with endocrine hormone changes.

(two) pathogenesis

The etiology and pathogenesis of PMR are still unclear. The cause may be multi-factor. Under the combination of internal factors and environment, the pathogenesis of the disease is considered to be related to HLA-DR4, suggesting that genetically susceptible infection may be the disease. One of the causes of the disease, in addition, the disease is almost all over 50 years old, suggesting that the disease is definitely related to age, the incidence of women is significantly higher than that of men, suggesting that this disease may also have a certain correlation with endocrine hormone changes. There are few pathological studies of PMR. There is no special pathological feature in PMR alone. The radial artery biopsy of some patients with PMR showed typical GCA pathological findings, suggesting that it is a potential GCA. In recent years, although large joint synovitis has been reported (such as knee) , sterno-lock joints can explain the symptoms of myalgia, and arthroscopic biopsy and synovial examination support the presence of synovitis, but this is controversial, muscle biopsy is normal or non-specific changes, such as type II muscle atrophy, PMR There are reports of granulomatous myocarditis and hepatitis.

an examination

Related inspection

Articular cavity examination arthroscopy

Laboratory examinations must be summarized and analyzed based on objective materials and medical examinations, and several possible diagnostics are proposed, and then further examinations are performed to confirm the diagnosis. According to the patient's symptoms, blood, urine, stool, erythrocyte sedimentation rate, CRP, comprehensive biochemical examination (liver function, renal function, muscle zymogram, etc.), serological examination, joint fluid examination, immunological examination of bone and joint X-ray film, CT examination .

Differential diagnosis

Differential diagnosis:

1. Rheumatoid arthritis: rheumatoid arthritis is a chronic systemic autoimmune disease characterized by joint synovitis. Prolonged recurrent episodes of synovitis can lead to destruction of cartilage and bone in the joints, joint dysfunction, and even disability. Vasculitis lesions involve various organs of the body, so this disease is also known as rheumatoid disease.

2. Rheumatoid arthritis: rheumatoid arthritis is a common acute or chronic connective tissue inflammation. It can recur and affect the heart. Clinically, it is characterized by joint and muscle migratory sorrow, sorrow, and pain. It is an allergic disease. It is one of the main manifestations of rheumatic fever, mostly caused by acute fever and joint pain.

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