Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Symptoms

Kyle J. Norton (Scholar)

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Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia

                     

                  Polymyalagia Arthritis (Rheumatica)


Polymalagia Arthritis is defined as a condition a common inflammatory rheumatic disease which causes pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdle as a result of the presence of a synovitis in proximal joints and periarticular structures.

                         The Symptoms 

1.  Dr. Kennedy-Malone LM, and Dr. Enevold GL. at the University of North Carolina School of Nursing in Greensbor, showed that Polymyalgia rheumatica (PMR) is a rheumatic condition with pain and stiffness, primarily in the neck, shoulders, hips, and pelvic girdle.(3).  The prevalence of polymyalgia rheumatica is approximately 16.8 to 53.7 per 100,000 of the population >50 years of age(5)

2.  Hôpital Ballangerstudy in differentiation of crowned dens syndrome were misdiagnosed as polymyalgia rheumatica, giant cell arteritis, meningitis or spondylitis suggested that symptoms of PRA may also include fever, cervical stiffness, headaches and biological inflammatory syndrome(4).

3. Low back pain
Low back pain in patient with Polymalagia Rheumatica may be resulted of affecting predominantly extra-articular synovial structures, causing inflammation of lumbar bursae(5).

4. According to Eleonora Reicher Rheumatology Institute, Warszawa, Poland, Patients with RA may present with symptoms of malaise, fatigue, weight loss and other features suggesting inflammation(5).

5. Dr. Lim SH and Dr. McLeay G. also expressed concerns of the prevalence of PMR with symptoms and signs are often nonspecific in elderly as the syndrome pain and stiffness in the proximal muscles, anorexia, fatigue, depression, weight loss, fever and temporal headache(6).

6. Other symptoms have also been found to associate to patient with PMA including sleep disturbance. anxiety, and depression, according to the joint study lead by the University of Leeds(7).

7. The disease is also found to be influential to patient poor functional impact; impact on daily schedule(8) as a result of "overwhelming" symptoms, in prevented them carrying out "fundamental activities" and "generally living life"(8).

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References

(3) Assessment and management of polymyalgia rheumatica in older adults by Kennedy-Malone LM1, Enevold GL.(PubMed)

(4) Crowned dens syndrome misdiagnosed as polymyalgia rheumatica, giant cell arteritis, meningitis or spondylitis: an analysis of eight cases by Aouba A1, Vuillemin-Bodaghi V, Mutschler C, De Bandt M.(PubMed)

(5) [Polymyalgia rheumatica mimicking neoplastic disease--significant problem in elderly patients].
[Article in Polish] by Kwiatkowska B1, Filipowicz-Sosnowska A.(PubMed)

(6) Locked jaw in polymyalgia rheumatica by Lim SH1, McLeay G.(PubMed)

(7) Polymyalgia Rheumatica (PMR) Special Interest Group at OMERACT 11: outcomes of importance for patients with PMR by Mackie SL1, Arat S, da Silva J, Duarte C, Halliday S, Hughes R, Morris M, Pease CT, Sherman JW, Simon LS, Walsh M, Westhovens R, Zakout S, Kirwan JR.(PubMed)

(8) "An impediment to living life": why and how should we measure stiffness in polymyalgia rheumatica? by Mackie SL1, Hughes R2, Walsh M2, Day J3, Newton M3, Pease C4, Kirwan J5, Morris M6.(PubMed)

(8) A case of polymyalgia rheumatica following influenza B infection by Iwata K1, Mizuno Y2.(PubMed