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

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

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 Diagnosis 

There is no specific test to diagnose polymyalgia rheumatica. If you are over age of 60 with some of the symptoms mentioned above without joint swelling, Joint tenderness, decreased range of motion in joints, Visible joint damage, etc., you may be already on the early onset of Polymyalgia Rheumatica(PMR)
Dr. Loeslie V said, ..." diagnosis of rheumatologic disorders in the elderly is often complicated " (due to) "clinician’s inability to differentiate among similar manifestations of rheumatologic disorders, the presence of comorbid conditions, and symptoms attributed simply to aging"(76).

1. Blood test
a. Erythrocyte sedimentation rate (ESR) is the blood test to exam the red blood cells in a test tube. he higher the ESR value is an indication of inflammation. Requisite indication of erythrocyte sedimentation rate (ESR)>40 mm/h is considered an important for the diagnosis of polymyalgia rheumatica (PMR)(78). Error reading may occur, normal erythrocyte sedimentation rate (ESR) reading has found to presence to approximately one-fifth of all PMR patients, more commonly in men(77).  A patient with PMR with an ESR lower than 40 mm/h is rare but has happened to men of that represent a clinically less severe than the classic form of PMR(78).

b. C-reactive protein (CRP)
Blood test measures the levels of C-reactive protein (CRP) produced by the liver in response to an injury or infection and people with polymyalgia rheumatic.Patient with PMR are associated to elevation of levels of both erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)(79).

c. Blood test for thrombocytes
Patient with polymyalgia rheumatica have an unusually high number of thrombocytosis. On the other hand, People with anemic polymyalgia rheumatica have a lower number of red blood cells than normal. The associated of thrombocytosis acted as  an inflammation parameter to rheumatic diseases such as Rheumatic Polymyalgia is found to be correlated to disease activity(81)

d. Rheumatoid factor (RF)
RF is an antibody, a protein made by the immune system presented in the blood of people with rheumatoid arthritis, but not in the blood of people with polymyalgia rheumatica(82).

2. Biopsy
Polymyalgia rheumatica is often associated with giant cell arteritis with biopsy by taking a small sample from the scalp artery in the emporal artery and examined under a microscope in a laboratory(83). The biopsy would be helpful to rule the presence of giant cell arteritis through observation of abnormal cells in the artery walls

The Southend University Hospital diagnosed criteria of PMR include "patients ≥50 years old presenting with bilateral shoulder pain, not better explained by an alternative pathology, can be classified as having PMR in the presence of morning stiffness >45 minutes, elevated C-reactive protein and/or erythrocyte sedimentation rate, and new hip pain"(80).

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You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

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Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

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REFERENCES

(76) Pain in the elderly: polymyalgia rheumatica by Loeslie V1.(PubMed)

(77) Polymyalgia rheumatica in patients with a normal erythrocyte sedimentation rate by Helfgott SM1, Kieval RI.(PubMed)

(78) Polymyalgia rheumatica without significantly increased erythrocyte sedimentation rate. A more benign syndrome by González-Gay MA1, Rodríguez-Valverde V, Blanco R, Fernández-Sueiro JL, Armona J, Figueroa M, Martínez-Taboada VM.(PubMed)
(79) Diagnosis, differential diagnosis and treatment of polymyalgia rheumatica by Nothnagl T1, Leeb BF.(PubMed)
(80) 2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative by Dasgupta B1, Cimmino MA, Kremers HM, Schmidt WA, Schirmer M, Salvarani C, Bachta A, Dejaco C, Duftner C, Jensen HS, Duhaut P, Poór G, Kaposi NP,Mandl P, Balint PV, Schmidt Z, Iagnocco A, Nannini C, Cantini F, Macchioni P, Pipitone N, Del Amo M, Espígol-Frigolé G, Cid MC, Martínez-Taboada VM,Nordborg E, Direskeneli H, Aydin SZ, Ahmed K, Hazleman B, Silverman B, Pease C, Wakefield RJ, Luqmani R, Abril A, Michet CJ, Marcus R, Gonter NJ, Maz M,Carter RE, Crowson CS, Matteson EL.(PubMed)

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Complications(2)

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

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 Complications(2)

The Most common complications for people with Polymyalgia Rheumatica(PMR)
1. Ischemic complications
Patient with Polymyalgia Rheumatica(PMR) are found to have an lower risk of developing ischemic events, according to University of Barcelona(63). Dr. Narváez J and the research team at the joint study lead by Hospital Universitario de Bellvitge-IDIBELL said," Patients with GCA presenting with apparently isolated PMR have a significant risk of developing transient or permanent disease-related ischemic complications" and "these complications occurred in 50% of the cases"(64). Some patient of PMR with thrombocytosis also are found to at greatest risk for the development of stroke as well(65).

2. Vascular events
DR. Staud R. said," Patients with polymyalgia rheumatica had a 2.6-fold increased risk for vascular events at a median 7.8 y"(66). Youngest age groups patient with Polymyalgia Rheumatica(PMR) are associated to the greatest risk of vascular events in comparison to other age group(67).

3. Interspinous bursitis

Interspinous bursitis, a frequent finding in the lumbar spine of patients with PMR is found to have a potential cause of spinal symptoms probably due to the presence of cervical and lumbar bursitis(68). Other study suggested that the complications of low back pain reported by patients with PMR may also be result of Inflammation of lumbar bursae, the Istituto di Ricovero e Cura a Carattere Scientifico study suggested(69).

4. Shoulder inflammation

Shoulder inflammation is found common in 50%patient with PMR(70). But according to the research lead by Dr. Curran JF , shoulder arthritis may be result of inflammatory, degenerative, and septic arthritis and rarely the initial joint involved in rheumatoid arthritis and generally the symptoms is respond to the basic management for rheumatoid arthritis(71).

5. Stress fractures
One of the complication of rheumatic disease, including Polymyalgia Rheumatica(PMR) may often be delayed or missed in diagnosis, leading to improper treatment, the Sourasky Medical Center suggested(72). Dr. Mäenpää HM and the research team at the Rheumatism Foundation Hospital said,"a patient with rheumatic disease experiences sudden and unexplained pain localised in the forefoot, above the ankle, below the knee, or in the pelvis, a stress fracture should be suspected"(73).

6. Infection diseases
Patient with Polymyalgia Rheumatica(PMR) are found to be susceptible to the complications of infectious diseases, such as Chronic Epstein-Barr virus infection(74), Mycoplasma pneumoniae infection(75),........

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

REFERENCES
(63) Development of ischemic complications in patients with giant cell arteritis presenting with apparently isolatedpolymyalgia rheumatica: study of a series of 100 patients by Hernández-Rodríguez J1, Font C, García-Martínez A, Espígol-Frigolé G, Sanmartí R, Cañete JD, Grau JM, Cid MC.(PubMed)
(64) Prevalence of ischemic complications in patients with giant cell arteritis presenting with apparently isolatedpolymyalgia rheumatica by Narváez J1, Estrada P2, López-Vives L2, Ricse M2, Zacarías A2, Heredia S2, Gómez-Vaquero C2, Nolla JM2.(PubMed)
(65) Thrombocytosis in polymyalgia rheumatica: an additional diagnostic criterion and possible risk factor for ischemic complications?by Harten P, Seyfarth B, Löffler H.(PubMed)
(66) Patients with polymyalgia rheumatica had a 2.6-fold increased risk for vascular events at a median 7.8 y by Staud R.(PubMed)
(67) Risk of vascular events in patients with polymyalgia rheumatica by Hancock AT1, Mallen CD2, Muller S1, Belcher J1, Roddy E1, Helliwell T1, Hider SL1.(PubMed)
(68) Interspinous bursitis is common in polymyalgia rheumatica, but is not associated with spinal pain by Camellino D, Paparo F, Morbelli S, Cutolo M, Sambuceti G, Cimmino MA.(PubMed)
(69) Lumbar interspinous bursitis in active polymyalgia rheumatica by Salvarani C1, Barozzi L, Boiardi L, Pipitone N, Bajocchi GL, Macchioni PL, Catanoso M, Pazzola G, Valentino M, De Luca C, Hunder GG.(PubMed)
(70)Shoulder arthritis. Distinguishing among the many causes of inflammation by Ellman MH, Brown NL, Curran JJ.(PubMed)
(71) Rheumatologic aspects of painful conditions affecting the shoulder by Curran JF, Ellman MH, Brown NL.(PubMed)
(72) Insufficiency fractures in rheumatic patients: misdiagnosis and underlying characteristics by Elkayam O1, Paran D, Flusser G, Wigler I, Yaron M, Caspi D.(PubMed)
(73) Insufficiency fractures in patients with chronic inflammatory joint diseases by Mäenpää HM1, Soini I, Lehto MU, Belt EA.(PubMed)
(74) "Chronic Epstein-Barr virus infection" syndrome and polymyalgia rheumatica by Buchwald D1, Sullivan JL, Leddy S, Komaroff AL.(PubMed)
(75) Synchronous variations of the incidence of temporal arteritis and polymyalgia rheumatica in different regions of Denmark; association with epidemics of Mycoplasma pneumoniae infection by Elling P1, Olsson AT, Elling H.(PubMed)

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

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

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.

                       

         Diseases associated with Polymyalgia Rheumatica(PMR)

1. Giant cell arteritis
 Giant cell arteritis shares many similarities with Polymyalgia rheumatica, according to the statistics
Patient with  Giant cell arteritis is associated to 50% higher risk of  polymyalgia rheumatica. On the other hand, there are 20% risk of development of Giant cell arteritis in patient polymyalgia, rheumatica. But the clinical manifestations, the relationship between GCA and PMR is not yet clearly established(48).
Medication and therapies used for treatment of polymyalgia rheumatica are also found effectively for giant cell arteritis as well, including Corticosteroids and anti-interleukin-6 receptor therapy(50).

2. Autoimmune thyroid disease and thyroid diseases
Autoimmune thyroid disease is defined as a condition in which the immune system wrongly viewed the thyroid gland and hormones produced as a foreign substances, thereby, producing antibodies to destroy them.  In a study of 250 patients with autoimmune thyroid disease, seven (2.8%) were found to have polymyalgia rheumatica. Female patient with age over 60 are found to have an increased risk of over 9.3% (49). Autoimmune thyroiditis is often related to Rheumatoid Arthritis due to other non-specific autoimmune organ diseases(51)

But according to the Service de Médecine Interne B, there is no evidences in support that the giant cell arteritis or polymyalgia rheumatica patients are at increased risk for hypothyroidism or hyperthyroidism(52)

3. Stroke
Besides cancer and heart diseases, stroke is the third leading cause of death. Approximate 1/4 of all stroke victims die as a direct result of the stroke or it's complications. The study of a total of 781 patients with PMR from the Taiwan Longitudinal Health Insurance Database between 2001 and 2005, patients with PMR are associated to an increased of stroke in comparison to controls(53).
Dr,.Hernández-Rodríguez J and the research team at the University of Barcelona suggested that Patients with GCA with apparently isolated PMR have a significant risk of developing ischemic complication(54).

4. Gastroesophageal reflux disease (GERD)
The prevalence of upper gastrointestinal (GI) diseases is increasing in subjects aged 65 years and over. Pathophysiological changes in esophageal functions that occur with aging may, at least in part, be responsible for the high prevalence of the disease. Use of medication of proton pump inhibitors (PPIs) are found to reduced risk of GERD in patient with polymyalgia rheumatica(55) in comparison to those without.

5. Vasculitis

Vasculitis is diseases associated to the inflammation of blood vessels. Patient with Polymyalgia Rheumatica(PMR) may present together with large vessel vasculitis (LVV) as a result of the inflammatory impact(56). Tocilizumab showed to improve symptoms of disease and inhibit inflammatory markers(57).Methotrexate effectively reduces relapse rate and lowers the cumulative dose of glucocorticoid therapy in patient with Polymyalgia Rheumatica(PMR)(58).

6. Peripheral vascular disease
Patient with Polymyalgia rheumatica, the most common inflammatory rheumatologic conditions in older adults are associated with an excess risk of vascular disease in comparison to the onset of vascular event in patients with and without polymyalgia rheumatica(59). Dr. Warrington KJ and the research team at the Mayo Clinic, Rochester said. "Patients with PMR appear to have an increased risk of PAD" in an inception cohort of all Olmsted County, Minnesota residents diagnosed with PMR between 1 January 1970 and 31 December 1999(60).

7. Renal function impairment 
Renal function impairment may associate rarely to patient with Polymyalgia Rheumatica(PMR). Only a few cases of AA amyloidosis secondary to PMR have been described in the literary data bases,according to the King's College Hospital NHS Foundation Trust(61). Dr. Escribá A and the research team at the Hospital Universitario 12 de Octubre, also expressed concerns of several cases of systemic amyloidosis associated with polymyalgia rheumatica (PMR) caused by massive amyloid deposition(62).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

REFERENCES
(48) Polymyalgia Rheumatica by  Ehab R Saad, MD, MA, FACP, FASN; Chief Editor: Herbert S Diamond, MD(Medscape)
(49) Autoimmune thyroid disease and the polymyalgia rheumatica-giant cell arteritis syndrome by Dent RG, Edwards OM.(PubMed)
(50) Giant cell arteritis and polymyalgia rheumatica: an update by González-Gay MA1, Pina T.(PubMed)
(51) [Chronic autoimmune thyroiditis and connective tissue system diseases].[Article in Slovak]by Macejová Z1, Benhatchi K, Lazúrová I.(PubMed)
(52) [Prevalence of hypothyroidism and hyperthyroidism in temporal arteritis and rhizomelic pseudopolyarthritis. A controlled study of 104 cases].[Article in French] by Juchet H1, Labarthe MP, Ollier S, Vilain C, Arlet P.(PubMed)
(53) Polymyalgia rheumatica and the risk of stroke: a three-year follow-up study by Kang JH1, Sheu JJ, Lin HC.(PubMed)
(54) Development of ischemic complications in patients with giant cell arteritis presenting with apparently isolatedpolymyalgia rheumatica: study of a series of 100 patients by Hernández-Rodríguez J1, Font C, García-Martínez A, Espígol-Frigolé G, Sanmartí R, Cañete JD, Grau JM, Cid MC(PubMed)
(55) Estimation of the symptoms for GERD by GerdQ in the patients with rheumatic diseases by Nozaki Y1, Kinoshita K1, Ri J1, Sakai K1, Shiga T1, Hino S1, Hirooka Y1, Sugiyama M1, Funauchi M1, Matsumura I1.(PubMed)
(56) (18)F-FDG PET/CT for the detection of large vessel vasculitis in patients with polymyalgia rheumatica by Lavado-Pérez C1, Martínez-Rodríguez I2, Martínez-Amador N1, Banzo I1, Quirce R1, Jiménez-Bonilla J1, De Arcocha-Torres M1, Bravo-Ferrer Z1, Jiménez-Alonso M1, López-Defilló JL1, Blanco R3, González-Gay MA3, Carril JM1.(PubMed)
(57) Tocilizumab for the treatment of large-vessel vasculitis (giant cell arteritis, Takayasu arteritis) and polymyalgia rheumatica by Unizony S1, Arias-Urdaneta L, Miloslavsky E, Arvikar S, Khosroshahi A, Keroack B, Stone JR, Stone JH.(PubMed)
(58) Methotrexate treatment in large vessel vasculitis and polymyalgia rheumatica by Spies CM1, Burmester GR, Buttgereit F.(PubMed)
(59) Risk of vascular events in patients with polymyalgia rheumatica by Hancock AT1, Mallen CD2, Muller S1, Belcher J1, Roddy E1, Helliwell T1, Hider SL1.(PubMed)
(60) Increased risk of peripheral arterial disease in polymyalgia rheumatica: a population-based cohort study by Warrington KJ1, Jarpa EP, Crowson CS, Cooper LT, Hunder GG, Matteson EL, Gabriel SE.(PubMed)
(61) Rapid development of renal failure secondary to AA-type amyloidosis in a patient with polymyalgia rheumatica by Javaid MM1, Kamalanathan M, Kon SP.(PubMed)
(62) Secondary (AA-type) amyloidosis in patients with polymyalgia rheumatica by Escribá A1, Morales E, Albizúa E, Herrero JC, Ortuño T, Carreño A, Dominguez-Gil B, Praga M.(PubMed)

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Complications(1)

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

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 Complications(1)

Patient with Polymyalgia Rheumatica(PMR) are limited to number daily physical functions and daily physical activities in most cases, according to Keele University and Mayo Clinic, the primary complications of PMR patients aref pain, stiffness and functioning(33)(34). Other more prevalence of complications of Polymyalgia Rheumatica(PMR) may include

1. Visual loss

Due to the nature of an inflammatory vasculopathy that involves large- and medium-sized arteries, patient with Polymyalgia Rheumatica(PMR) are associated to the complication of visual loss, according to the study by Dr. Schmidt J and Dr. Warrington KJ.(35). Dr.Hart FD. in the study of Visual complications of polymyalgia rheumatica (polymyalgia arteritica) siad," patients with polymyalgia rheumatica (polymyalgia arteritic) developed evidence of cranial arteritis (in one case two years and in one six months) following withdrawal of steroid therapy after apparent cure"(36).

2. Stroke
Polymyalgia rheumatica (PMR), a relatively common rheumatic disease, particularly in the elderly effecting the medium and large arteries causes of stroke(35). According to Taipei Medical University, PMR was associated with a significantly higher risk of stroke in the three-year follow-up period, in a study included 781 patients with PMR from the Taiwan Longitudinal Health Insurance Database between 2001 and 2005(37).

Dr. Narváez J and the research team at the Hospitalet de Llobregat said,"Patients with GCA presenting with apparently isolated PMR have a significant risk of developing transient or permanent disease-related ischemic complications; these complications occurred in 50% of the cases"(38).

3. Low back pain 

Interspinous bursitis associated with lower back pain, a frequent finding in the lumbar spine of patients with PMR may be as a result of Inflammation of lumbar bursae, according to Istituto di Ricovero e Cura a Carattere Scientifico in the finding by using magnetic resonance imaging (MRI)(39). The joint study lead by the University of Cantabri said,"The most common clinical manifestations at diagnosis were: PMR features, often with atypical clinical presentation (n=23 patients, 72%); diffuse lower limb pain (n=16 patients, 50%); constitutional symptoms (n=12 patients, 37%), inflammatory low back pain (n=9 patients, 28%) and fever (n=7 patients, 22%)(40).

4. Cervical interspinous bursitis
Cervical interspinous bursitis, an active inflammatory involvement of cervical bursae is likely to cause discomfort in the neck of patients(41) and also a frequent finding in the lumbar spine of patients with PMR(42). Although it is not associated with clinical symptoms, it has been found to associate to the spinal pain reported by the patients(42).

5. Renal failure

Patient with Polymyalgia rheumatica (PMR) may be important of monitoring renal function due to renel failure is found to associate to a few cases of AA amyloidosis(43), the King's College Hospital NHS Foundation Trust suggested.

According to the reports of Hospital Universitario 12 de Octubre, "two patients with PMR (one with associated GCA) who developed nephrotic syndrome and end-stage renal failure caused by massive amyloid deposition"(44)

6. Perforated colonic diverticular disease

The association of Polymyalgia Rheumatica(PMR) and perforated colonic diverticular disease may be result of proinflammatory expression and high incidence of other co-morbidities including colonic pathology(45), according to the joint study lead by the James Paget University Hospital.

7. Cancers

The investigation of a total of 185 patients with polymyalgia rheumatica (PMR) and temporal arteritis (TA) diagnosed during 1978-83 and their 925 matched controls with the data files at the Cancer Registry of Norway at the end of 1987, indicated that the malignancy of cancer are found to associate with 24% in patient with PMR(46).

Dr. Ji J and the research team at the Lund University said," Patients hospitalized for PMR and GCA had a marginally increased risk of cancer, with the highest risk noted for the first year after hospitalization. However, for specific cancers, such as skin cancer and leukaemia, the increases were still significant for patients diagnosed later than 1 year after hospitalization"(47).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer
REFERENCES
(33) The epidemiology of polymyalgia rheumatica in primary care: a research protocol.by Muller S1, Hider S, Helliwell T, Bailey J, Barraclough K, Cope L, Dasgupta B, Foskett R, Hughes R, Mayson Z, Purcell C, Roddy E, Wathall S, Zwierska I, Mallen CD.(PubMed)
(34) Patient-reported outcomes in polymyalgia rheumatica. by Matteson EL1, Maradit-Kremers H, Cimmino MA, Schmidt WA, Schirmer M, Salvarani C, Bachta A, Dejaco C, Duftner C, Slott Jensen H, Poór G, Kaposi NP,Mandl P, Balint PV, Schmidt Z, Iagnocco A, Cantini F, Nannini C, Macchioni P, Pipitone N, Del Amo M, Espígol-Frigolé G, Cid MC, Martínez-Taboada VM,Nordborg E, Direskeneli H, Aydin SZ, Ahmed K, Hazelman B, Pease C, Wakefield RJ, Luqmani R, Abril A, Marcus R, Gonter NJ, Maz M, Crowson CS, Dasgupta B.(PubMed)
(35) Polymyalgia rheumatica and giant cell arteritis in older patients: diagnosis and pharmacological management by Schmidt J1, Warrington KJ.(PubMed)
(36) Visual complications of polymyalgia rheumatica (polymyalgia arteritica) by Hart FD(PubMed)
(37) Polymyalgia rheumatica and the risk of stroke: a three-year follow-up study by Kang JH1, Sheu JJ, Lin HC.(PubMed)
(38) Prevalence of ischemic complications in patients with giant cell arteritis presenting with apparently isolatedpolymyalgia rheumatica by Narváez J1, Estrada P2, López-Vives L2, Ricse M2, Zacarías A2, Heredia S2, Gómez-Vaquero C2, Nolla JM2.(PubMed)
(39) Lumbar interspinous bursitis in active polymyalgia rheumatica by Salvarani C1, Barozzi L, Boiardi L, Pipitone N, Bajocchi GL, Macchioni PL, Catanoso M, Pazzola G, Valentino M, De Luca C, Hunder GG(PubMed)
(40) Non-infectious aortitis: a report of 32 cases from a single tertiary centre in a 4-year period and literature review by Loricera J1, Blanco R1, Hernández JL2, Carril JM3, Martínez-Rodríguez I3, Canga A4, Peiró E1, Alonso-Gutiérrez J2, Calvo-Río V1, Ortiz-Sanjuán F1, Mata C1,Pina T1, González-Vela MC5, Martínez-Amador N3, González-Gay MA6.(PubMed)
(41) Cervical interspinous bursitis in active polymyalgia rheumatica by Salvarani C1, Barozzi L, Cantini F, Niccoli L, Boiardi L, Valentino M, Pipitone N, Bajocchi G, Macchioni P, Catanoso MG, Olivieri I, Hunder GG.(PubMed)
(42) Interspinous bursitis is common in polymyalgia rheumatica, but is not associated with spinal pain by Camellino D, Paparo F, Morbelli S, Cutolo M, Sambuceti G, Cimmino MA.(PubMed)
(43) Rapid development of renal failure secondary to AA-type amyloidosis in a patient with polymyalgia rheumatica by Javaid MM1, Kamalanathan M, Kon SP.(PubMed)
(44) Secondary (AA-type) amyloidosis in patients with polymyalgia rheumatica by Escribá A1, Morales E, Albizúa E, Herrero JC, Ortuño T, Carreño A, Dominguez-Gil B, Praga M.(PubMed)
(45) Presentations of perforated colonic pathology in patients with polymyalgia rheumatica: two case reports by de Silva P1, Pranesh N, Vautier G.(PubMed)
(46) Cancer in association with polymyalgia rheumatica and temporal arteritis by Haga HJ1, Eide GE, Brun J, Johansen A, Langmark F.(PubMed)
(47) Cancer risk in patients hospitalized with polymyalgia rheumatica and giant cell arteritis: a follow-up study in Sweden by Ji J1, Liu X, Sundquist K, Sundquist J, Hemminki K.(PubMed)

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

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

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 Risk factors

1. Gene
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).

2. Aging
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)

3. Diet
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).

5. Smoking
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).

6. Gender
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).

5. Race
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).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

References

(20) Relationship between interleukin 6 promoter polymorphism at position -174, IL-6 serum levels, and the risk of relapse/recurrence in polymyalgia rheumatica by Boiardi L1, Casali B, Farnetti E, Pipitone N, Nicoli D, Cantini F, Macchioni P, Bajocchi G, Catanoso MG, Pulsatelli L, Consonni D, Salvarani C.(PubMed)
(21) [Polymyalgia rheumatica mimicking neoplastic disease--significant problem in elderly patients].
[Article in Polish]by Kwiatkowska B1, Filipowicz-Sosnowska A.(PubMed)

(22) Phagocyte dysfunction in polymyalgia rheumatica and other age-related, chronic, inflammatory conditions by Álvarez-Rodríguez L1, López-Hoyos M, Calvo-Alén J, Aurrecoechea E, Villa I, Martínez-Taboada VM.(PubMed)

(23) Serum cytokines and steroidal hormones in polymyalgia rheumatica and elderly‐onset rheumatoid arthriti by M Cutolo, C M Montecucco, L Cavagna, R Caporali, S Capellino, P Montagna, L Fazzuoli, B Villaggio, B Seriolo, and A Sulli(PMC)

(24) Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption by Pattison DJ1, Symmons DP, Lunt M, Welch A, Luben R, Bingham SA, Khaw KT, Day NE, Silman AJ.(PubMed)

(25) Epidemiology of polymyalgia rheumatica by Cimmino MA1, Zaccaria 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)

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

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

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 causes 

The cause of PMR is not well understood, but researchers believe it is a result of the abnormal inflammatory activity of inflammatory cells and proteins of the immune system due to the presence of a synovitis in proximal joints and periarticular structures, causes by the following

1. Influenza B infection

Number of infectious agents have been found to induce the cause of polymyalagia rheumatica(PMR) associated to human leukocyte antigens (HLAs), such as HLA-DRB1 and HLA-DQB(10). According to the Kobe University Hospital, contracting influenza virus B is also found to influence to the development of PMR(9). Dr. Peris P said," Onset of symptoms in PMR is unrelated to seasonal pattern. Yet almost 50% of cases occurred in the months of May, February, and August"(12) and there is no association between infection and onset of polymyalgia rheumatica(13), the Ciudad Sanitaria y Universitaria de Bellvitge argued.

2. Genetic factors

In the study to evaluate HLA-DRB1 associations in patients with polymyalgi arheumatica (PMR), acording to the study based HLA-DRB1 genotyping in 89 PMR patients, 44 GCA patients, and 99 unrelated healthy controls from the same geographic area(10). Dr Pease CT and the research team at the University of Leeds, in the diagnosed of musculoskeletal disorder said, "the presence of HLA-DRB1*04 may indicate underlying RA or TA."(11)

3. Environmental factors

Environmental contagious factors have been found to link to the onset of at least 1/4 percent of the patient with PMR, according to the study of 460 patients (128 with isolated PMR, 227 with isolated GCA, 105 with PMR/CGA), by the Dupuytren University Hospital, Limoges(14).

According to the database of the World Health Organisation (WHO), statin, the prescribed medication for lowering blood cholesterol levels, using Anatomical Therapeutic Chemical (ATC) classification, may be may be associated with the occurrence of PMR(15).

Some researchers including Goëb V also concerned the risk of  Cerivastatin-induced PMR(16) and patient reexposure to a statin is also associated to the developed polymyalgia rheumatica(17).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

References
(9) HLA-DRB1 allele distribution in polymyalgia rheumatica and giant cell arteritis: influence on clinical subgroups and prognosis by Martínez-Taboda VM1, Bartolome MJ, Lopez-Hoyos M, Blanco R, Mata C, Calvo J, Corrales A, Rodriguez-Valverde V.(PubMed)
(10) HLA-DRB1 allele distribution in polymyalgia rheumatica and giant cell arteritis: influence on clinical subgroups and prognosis by Martínez-Taboda VM1, Bartolome MJ, Lopez-Hoyos M, Blanco R, Mata C, Calvo J, Corrales A, Rodriguez-Valverde V.(PubMed)
(11) Diagnosing late onset rheumatoid arthritis, polymyalgia rheumatica, and temporal arteritis in patients presenting with polymyalgic symptoms. A prospective longterm evaluation by Pease CT1, Haugeberg G, Morgan AW, Montague B, Hensor EM, Bhakta BB.(PubMed)
(12) Polymyalgia rheumatica is not seasonal in pattern and is unrelated to parvovirus b19 infection by Peris P1.(PubMed)
(13) Lack of association between infection and onset of polymyalgia rheumatica by Narváez J1, Clavaguera MT, Nolla-Solé JM, Valverde-Garcia J, Roig-Escofet D.(PubMed)
(14) Familial aggregation in giant cell arteritis and polymyalgia rheumatica: a comprehensive literature review including 4 new families by Liozon E1, Ouattara B, Rhaiem K, Ly K, Bezanahary H, Loustaud V, Letellier P, Drouet M, Vidal E.(PubMed)
(15) Statin-associated polymyalgia rheumatica. An analysis using WHO global individual case safety database: a case/non-case approach by de Jong HJ1, Saldi SR, Klungel OH, Vandebriel RJ, Souverein PC, Meyboom RH, Passier JL, van Loveren H, Cohen Tervaert JW.(PubMed)
(16) Cerivastatin-induced polymyalgia rheumatica-like illness by Goëb V, Guillemant N, Vittecoq O, Le Loët X.(PubMed)
(17) Giant cell arteritis and polymyalgia rheumatica after reexposure to a statin: a case report by de Jong HJ, Meyboom RH, Helle MJ, Klungel OH, Niskanen L, Cohen Tervaert JW.(PubMed)

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

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

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).

All Forms of Arthritis are Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

Super foods Library, Eat Yourself Healthy With The Best of the Best Nature Has to Offer

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