Polymyalgia rheumatica

Polymyalgia rheumatica is a clinical syndrome of unknown aetiology characterised by aching and stiffness in the shoulder girdle, pelvic girdle, and neck that occurs in people aged over 50 years. Polymyalgia rheumatica is generally associated with giant-cell arteritis, frequently occurring in the same patient. However, the nature of the association is not known. The first description of polymyalgia rheumatica was made by Bruce in 1888, who defined typical polymyalgia rheumatica clinical findings in five patients as senile rheumatic gout. Only 60 years later Bagratuni described a group of patients with polymyalgia rheumatica articular manifestations as having “anarthritic rheumatoid disease”. Bagratuni followed the clinical course of these patients for more than 10 years, and did not observe any progression in erosive arthritis; he judged this disease to be a mild form of rheumatoid arthritis. The term polymyalgia rheumatica for this disorder was suggested by Barber in 1957. During the 1960s, polymyalgia rheumatica was generally accepted as a different disease from rheumatoid arthritis and giant-cell arteritis. However, Scandinavian clinicians deem polymyalgia rheumatica to be a manifestation of a generalised arteritis and generally use the term giant-cell arteritis to define polymyalgia rheumatica/giant-cell arteritis as a whole.