Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- rigidez da cintura escapular/pélvica
- dor na cintura escapular/pélvica
- resposta rápida aos corticosteroides
Outros fatores diagnósticos
- início agudo
- febre baixa
- anorexia
- perda de peso
- mal-estar
- depressão
- astenia
- artrite oligoarticular
Fatores de risco
- idade ≥50 anos
- arterite de células gigantes (ACG)
- sexo feminino
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- velocidade de hemossedimentação (VHS)
- proteína C-reativa
- Hemograma completo
Investigações a serem consideradas
- hormônio estimulante da tireoide (TSH)
- ultrassonografia
- RNM
- eletroforese de proteínas séricas
- fator reumatoide
- anticorpos antipeptídeos citrulinados cíclicos
Novos exames
- interleucina 6 (IL-6)
- tomografia por emissão de pósitrons (PET) com fluordesoxiglucose F-18
Algoritmo de tratamento
apresentação inicial
resistência ao tratamento, recidiva ou exacerbação da doença
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
Disclosures
AW declares that he has no competing interests.
Acknowledgements
Dr Ari Weinreb would like to gratefully acknowledge Dr Lynell Newmarch, a previous contributor to this topic.
Disclosures
LN declares that she has no competing interests.
Peer reviewers
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
Disclosures
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
Disclosures
KC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Nothnagl T, Leeb BF. Diagnosis, differential diagnosis and treatment of polymyalgia rheumatica. Drugs Aging. 2006;23:391-402. Abstract
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. Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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