Rheumatic polymyalgia. MCSC patient history
Newspatient m., 85 years old, was admitted to the rheumatology department of the MCSC with complaints of:
- pain and restriction of movement in the shoulder and hip joints;
- pain in the muscles of the shoulders and pelvis;
- morning stiffness;
- general weakness and fatigue;
- lack of appetite.
In 2000, she was diagnosed with a joint disease - osteoarthritis. For its treatment, nonsteroidal anti-inflammatory drugs and drugs for the restoration of cartilage tissue (chondroprotectors) were prescribed courses.
In December 2021, there was pain and stiffness in the muscles of the shoulder and pelvis, a decrease in body weight by 12 kg in 6 months due to lack of appetite and general weakness. Against the background of taking painkillers, there was no improvement in the condition.
The woman sought medical help at the clinic. according to the results of the examination, deviations in laboratory blood tests were revealed, and a consultation with a rheumatologist of the MCSC named after a.s. loginov was recommended.
The patient was hospitalized for further examination and treatment in the rheumatology department with suspected inflammatory disease of the musculoskeletal system - "Polymyalgia rheumatica".
During the inspection, the specialists of the department drew attention to:
- pain and symmetrical restriction of movement in the shoulder and hip joints;
- soreness on palpation of the muscles of the shoulder and hip on both sides.
A comprehensive diagnosis was carried out, which did not reveal oncopathology and confirmed the diagnosis of polymyalgia rheumatica. The patient was given effective drug therapy (taking systemic glucocorticoids), which had a positive effect and improved well-being. Today she adheres to the prescribed treatment and is dynamically observed in our Center.
Polymyalgia rheumatica (PCMA) is a chronic inflammatory disease of unknown etiology, affecting mainly the elderly. RPMA can manifest as an independent disease or be combined with giant cell arteritis.
Clinical manifestations of the disease:
- Acute onset (2 weeks)
- Symmetrical pain and limited movement in the shoulder and hip joints
- Pain and stiffness in the muscles of the shoulder and pelvic girdle
- Pain and stiffness in the cervical spine
- Morning stiffness (more than 45 minutes)
- Increased markers of inflammation (ESR, CRP)
- General weakness, subfebrility, weight loss
- Rapid clinical effect in the appointment of systemic glucocorticoids.
Due to the similarity of symptoms, differential diagnosis of RAMA is carried out with various rheumatic diseases.:
- Inflammatory - rheumatoid arthritis, polymyasitis, etc.
- Degenerative – osteoarthritis, adhesive capsulitis.
In addition, manifestations of PMA in the framework of paraneoplastic syndrome are not uncommon – signs that appear with malignant neoplasm as a result of the body's reaction to the tumor. In this regard, patients with suspected PMA are recommended to conduct an examination to identify oncological pathology.
In most patients, the prognosis for recovery is favorable. However, without the use of drugs (systemic glucocorticoids), it takes a chronic wave-like course.
to make an appointment for a consultation with a rheumatologist at the MCSC named after a.s. loginov, you can contact the information and help desk of the center by phone 8 (800) 234-24-22 or use the online schedule on the website.
