[Polymyalgia arteriitica (rheumatica)].

Abstract

The polymyalgia arteritica (PMA) is a systemic disease characterized by symmetrical muscle pain of the shoulder and/or pelvic girdle and a highly inflammatory constellation of non-specific inflammation parameters. The symptoms in the mostly elderly patients may perfectly imitate a malignancy of syndrome. Besides showing arthralgia and arthritis nearly 50% of cases will develop an arteritis localized most frequently at the arteria temporalis. Decisive diagnostic criteria are muscle pain in the shoulder/pelvis girdle and a markedly raised erythrocyte sedimentation rate. Other diagnostic classification, laboratory findings, X-ray, non-invasive techniques such as sonography are of no use in assessment of the diagnosis. Successful treatment provides corticosteroid therapy applied in a circadian rhythm. The alternating therapy lately often recommended does not completely suppress the symptoms. Obligatory is a warning against a too early stop of therapy as well as too low corticosteroid dosage. Exclusive non-steroidal antirheumatic therapy not only is not sufficient but will prove dangerous (arteritis). Although limiting itself after a duration of about 2 to 10 years, even without treatment, the PMA must not be labelled as benign due to its risk of arteritis.