Distal musculoskeletal manifestations in polymyalgia rheumatica

In polymyalgia rheumatica (PMR) the marked and distinctive symptoms of proximal aching and stiffness have tended to draw attention away from the distal musculoskeletal manifestations which also occur in this syndrome. Peripheral manifestations are present in about half of all cases of PMR and include joint synovitis, diffuse swelling of the distal extremities with or without pitting edema, tenosynovitis and carpal tunnel syndrome. Awareness of these findings will help to facilitate the proper diagnosis and institution of appropriate therapy for this disease.