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Types of Musculo-Skeletal disorders in elder(2)
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
7. Low back pain
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.
Patient carrying gene of rs20541 (R130Q) polymorphism in the IL-13 gene is showed to have an increased risk of Polymyalgia Rheumatica(PMR)(18). In elder, genetic abnomality of IL1RN polymorphism is also an risk factor for the disease but not associated to PMR severity(19), according Universidad de Cantabria. The influence of persistence high levels of interleukin 6 (IL-6)(Proinflammatory cytokines) also elevated the risk of PMR (20).
If you are over 50 years of age, you are at increased risk of Polymalagia Arthritis (PMR)(21), as a result of age-related chronic inflammatory conditions in increased effector functions of phagocytes, chemotaxis, phagocytosis, and oxidative burst as well as reduced immunity(22). In support to the above, the Slovak Academy of Sciences study suggested that patient with Polymyalgia Rheumatica(PMR) are found to have low levels of cortisol, during ongoing inflammation, decreased levels of adrenal androgens which is an expression in aging population(23)
Diet plays an important in reduced and increased risk of PMR, depending to specific dietary components. Intake of red meat and certain dietary components have shown to predict the onset of Polymyalgia Rheumatica(PMR) depending to influential risk from other lifestyle causes(24).
4. Geographical and temporal differences
People who live in ceratain Geographical and temporal areas are susceptible to increased risk of Polymyalgia Rheumatica(PMR). Dr Cimmino MA and Zaccaria A said," Epidemiological studies have helped to unravel the etiopathogenic factors at work in PMR/GCA,... the incidence of PMR varies between 12.7/100,000 in Italy and 112.6/100,000 in Norway"(25).
One of most additive form of human life style of thousands of year has found to causes many types of deathly cancer and viarity of chronic inflammatory diseases, including Polymyalgia Rheumatica(PMR)(25). According to the Kameda Medical Center, reviewed of review of patients with RS3PE and PMR treated in a community-based hospital between January 2000 and December 2009, smiking is the leading causes of PMR with the effective rate of 39%(26).
Dr. Harrison BJ and the research team at the University of Manchester, insisted that Cigarette smoking is known to increase rheumatoid factor (RF) and nodule formation in patients with rheumatoid arthritis (RA) and the early inflammatory polyarthritis (28).
According to the review of records of 163 cases of PMR and/or TA diagnosed over a 15 year period,
if you are women, you are at increased risk to develop Polymalagia Arthritis with severity of inflammatory response(29). Dr. Dejaco C, the leading researcher at the jopint study said,"Among prognostic factors, female sex, high erythrocyte sedimentation rate (ESR) and peripheral arthritis were associated in some studies with a higher relapse risk"(30).
Polymyalgia Rheumatica(PMR) is one of most common rheumatic diseases in Asian popilation specially in China and Singapore, according to Singapore General Hospital(31) and Community Oriented Program for Control of Rheumatic Diseases (32) but The prevalence of rheumatic complaints varied with the locality surveyed(32)
Some researchers also suggested that increased levels of Procalcitonin (PCT) as an early marker of bacterial infection in patients diagnosed during the 2002-06 period randomly selected.may be correlated with inflammation status of the early onset of PMR as well as sun exposure, and nulliparity(27).
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(21) [Polymyalgia rheumatica mimicking neoplastic disease--significant problem in elderly patients].
[Article in Polish]by Kwiatkowska B1, Filipowicz-Sosnowska A.(PubMed)
(26) Clinical characteristics of patients with remitting seronegative symmetrical synovitis with pitting edema compared to patients with pure polymyalgia rheumatica by Kimura M1, Tokuda Y, Oshiawa H, Yoshida K, Utsunomiya M, Kobayashi T, Deshpande GA, Matsui K, Kishimoto M.(PubMed)
(27) Procalcitonin at the onset of giant cell arteritis and polymyalgia rheumatica: the GRACG prospective study by Schmidt J1, Duhaut P, Bourgeois AM, Salle V, Smail A, Chatelain D, Betsou F, Mazière JC, Ducroix JP; Groupe de Recherche sur l'Artérite à Cellules Géantes (GRACG).(PubMed)