Symptoms That May Arise in Patients With PMR
Diagnostic symptoms1
Joint pain and/or stiffness
In ≥2 of the neck or torso; shoulders or proximal regions of the arms; or hips or proximal aspects of the thighs
Morning stiffness
Lasting for >45 minutes
Symptoms not explained by infection, joint damage, or other rheumatological disease
Symptoms are nonspecific, differential diagnoses should be ruled out (eg, rheumatoid arthritis, spondyloarthritis)
Additional manifestations1
Systemic symptoms
Fever, anorexia, weight loss,
and fatigue
Cranial symptoms suggestive of GCA
New headache, jaw claudication, scalp tenderness, visual change, fever, or cough
Frequency of inflammatory manifestations
39% of PMR patients had presented with peripheral synovitis2
Pathways in the
Development of PMR
Immune-related disorder with elevated inflammatory markers as one of its most common features.
People with PMR can present with bilateral aches or pains, particularly at the joints, such as the hips or shoulders.
The precise pathophysiology remains unclear; however, a mild synovitis with CD4+ T cells and macrophage infiltration characterize arthoscopic biopsies.
Extracapsular soft tissue edema and inflammation that are symmetrical in nature differentiate PMR from other rheumatic conditions, with musculotendinous inflammation representing the defining pathology.1,2
- Immune-related disorder with a poorly understood pathophysiology1
- CD4+ cells stimulate the production of IL-6, which plays a central role in mediating inflammation1
- Th17 cells are inducers of chronic inflammation through production of IL-17, which activates many cells including macrophages, endothelial cells and smooth muscle cells2
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