Polymyalgia rheumatica
Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- shoulder/hip girdle stiffness
- shoulder/hip girdle pain
- rapid response to corticosteroids
Outros fatores diagnósticos
- acute onset
- low-grade fever
- anorexia
- weight loss
- malaise
- depression
- asthenia
- oligoarticular arthritis
Fatores de risco
- age ≥50 years
- giant cell arteritis (GCA)
- female sex
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
- CBC
Investigações a serem consideradas
- TSH
- ultrasound
- MRI
- serum protein electrophoresis
- serum creatine phosphokinase
- rheumatoid factor
- anti-cyclic citrullinated peptide antibodies
Novos exames
- interleukin (IL)-6
- fluorodeoxyglucose F-18 PET scan
Algoritmo de tratamento
initial presentation
treatment-resistant or relapse or disease exacerbation
Colaboradores
Autores
Ari Weinreb, MD, PhD
Associate Chief of Rheumatology
VA Greater Los Angeles Healthcare System
Associate Clinical Professor of Medicine
David Geffen School of Medicine at UCLA
Los Angeles
CA
Declarações
AW declares that he has no competing interests.
Agradecimentos
Dr Ari Weinreb would like to gratefully acknowledge Dr Lynell Newmarch, a previous contributor to this topic.
Declarações
LN declares that she has no competing interests.
Revisores
Brian F. Mandell, MD, PhD, FACR
Vice Chairman of Medicine for Education
Professor of Medicine
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University
Editor in Chief
Cleveland Clinic Journal of Medicine
Cleveland Clinic
Cleveland
OH
Divulgaciones
BFM declares that he has no competing interests.
Kuntal Chakravarty, FRCP (London), FRCP (Glasgow), FRCP (Ireland), FACP (USA), FACR (USA)
Consultant Rheumatologist
BHRT University Hospital
Queen’s Hospital
Romford
UK
Divulgaciones
KC declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Nothnagl T, Leeb BF. Diagnosis, differential diagnosis and treatment of polymyalgia rheumatica. Drugs Aging. 2006;23:391-402. Resumen
Buttgereit F, Dejaco C, Matteson EL, et al. Polymyalgia rheumatica and giant cell arteritis: A systematic review. JAMA. 2016 Jun 14;315(22):2442-58. Resumen
Dejaco C, Singh YP, Perel P, et al; European League Against Rheumatism; American College of Rheumatology. 2015 recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheumatol. 2015;67:2569-2580.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Giant cell arteritis (GCA)
- Early rheumatoid arthritis (RA)
- Hypothyroidism
Más DiferencialesGuías de práctica clínica
- 2022 guideline for the prevention and treatment of glucocorticoid induced osteoporosis
- 2022 guideline for vaccinations in patients with rheumatic and musculoskeletal disease
Más Guías de práctica clínicaFolletos para el paciente
Polymyalgia rheumatica
Más Folletos para el pacienteVideos
Venepuncture and phlebotomy: animated demonstration
Más vídeos
Inicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad