Polymyalgia Rheumatica
Basics
Description
- An inflammatory clinical syndrome characterized by pain and morning stiffness of the shoulder, hip girdles, and neck; primarily impacts patients aged >50 years; associated with morning stiffness and elevated markers of inflammation
- Can be associated with giant cell arteritis (GCA)
- System(s) affected: musculoskeletal; hematologic/lymphatic/immunologic
- Synonym(s): senile rheumatic disease; polymyalgia rheumatica (PMR) syndrome; pseudo-polyarthrite rhizomélique
Geriatric Considerations
Incidence increases with age (age >50 years).
Pediatric Considerations
Rare in patients <50 years of age (1)
Epidemiology
Incidence
- Incidence increases after age 50 years. Incidence of PMR and GCA in the United States is 50 and 18 per 100,000 people, respectively.
- Predominant sex: female > male (2 to 3:1)
- Most common in Caucasians, especially those of Northern European ancestry and in Scandinavian countries
- Peak incidence occurs between ages 70 and 80 years.
Prevalence
Prevalence in those >50 years old: 700/100,000
Etiology and Pathophysiology
- Unknown; symptoms relate to enhanced immune system and periarticular inflammatory activity.
- Pathogenesis
- Polygenic; involves multiple environmental and genetic factors
- Significant association between histologic evidence of GCA and parvovirus B19 DNA in temporal artery specimen
Genetics
Associated with human leukocyte antigen determinants (HLA-DRB1*04 and DRB1*01 alleles)
Risk Factors
- Aged >50 years
- Presence of GCA
Commonly Associated Conditions
Concurrent GCA (temporal arteritis) in ~15–30% of patients; more commonly in females than males
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Domino, Frank J., et al., editors. "Polymyalgia Rheumatica." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116475/all/Polymyalgia_Rheumatica.
Polymyalgia Rheumatica. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116475/all/Polymyalgia_Rheumatica. Accessed December 10, 2024.
Polymyalgia Rheumatica. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116475/all/Polymyalgia_Rheumatica
Polymyalgia Rheumatica [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 10]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116475/all/Polymyalgia_Rheumatica.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Polymyalgia Rheumatica
ID - 116475
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116475/all/Polymyalgia_Rheumatica
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -