Polymyalgia rheumatica (PMR) causes symptoms similar to those of several other conditions, such as rheumatoid arthritis, lupus, and fibromyalgia. For this reason, doctors can misdiagnose it. Show PMR causes widespread muscle stiffness, aching, and pain that is often worse in the morning or after extended periods of inactivity. It affects both sides of the body equally and is common in those over 50 years of age. Other symptoms of PMR include:
This article looks at the diseases that mimic PMR, including their similarities and differences. It also explains how doctors tell these conditions apart and make a diagnosis. According to the American College of Rheumatology, PMR is a condition that causes widespread aching and stiffness in joints around the body. It often affects the:
The average age of onset is 70 years old. PMR can affect anyone, but it occurs slightly more often in females than males and is more common in white people. The reasons for this are unclear. Doctors do not know what causes PMR, but it appears to be driven by inflammation. PMR typically lasts between 1–5 years before resolving, but this can vary. During that time, people can manage the symptoms using medications, exercise, and rest. Approximately 15% of people with PMR also develop a potentially serious condition known as giant cell arteritis, which causes narrowing or blockages in large blood vessels around the head, neck, and arms. The symptoms of giant cell arteritis include:
Polymyalgia rheumatica shares many symptoms with a range of other diseases, including:
RA is an autoimmune disease that occurs when the immune system attacks the joints. It causes pain and stiffness in the joints, similar to PMR. People with RA can also experience fatigue, a high temperature, low appetite, and weight loss. Due to these similarities, RA and PMR are easy to mix up. Additionally, both RA and PMR tend to affect both sides of the body and occur more frequently in older adults. Around 30% of people with PMR have joint swelling and degeneration, which are also symptoms of RA. However, there are some differences between the symptoms of PMR and RA. Not everyone with PMR will develop joint swelling, whereas in RA, this is a key symptom. Additionally, RA often begins in the hands, feet, wrists, and ankles. PMR does not usually affect these joints. Lupus is another autoimmune condition. However, instead of the immune system specifically attacking the joints, it attacks various tissues and organs. The main symptoms are joint and muscle pain, a rash over the nose and cheeks, and extreme fatigue. Aside from the butterfly-shaped rash on the face, lupus can seem very similar to PMR. Other symptoms of lupus may include:
Fibromyalgia is a condition that causes chronic pain across the body. Similar to PMR, it causes muscle stiffness and tension, especially in the morning. It can also cause fatigue. Other symptoms of fibromyalgia include:
A key difference between fibromyalgia and PMR is that fibromyalgia is not inflammatory, so it will not respond to medications that reduce pain by lowering inflammation. Lyme disease is a bacterial infection that spreads through tick bites. It causes joint pain and stiffness, fever, and fatigue, much like PMR. It can also cause:
If Lyme disease is left untreated, it can cause more advanced symptoms, such as:
As ticks are tiny, their bites are easy to miss. Additionally, while there are tests for Lyme disease, they are not always accurate. If Lyme disease is a possibility, a doctor may prescribe antibiotics to treat the infection. If they do not work, it may indicate that Lyme disease is not the cause of the symptoms. People with cancer experience some of the symptoms associated with PMR, including fatigue, fever, loss of appetite, and weight loss. There is also an association between a PMR diagnosis and an increased risk of cancer. A 2020 study found a higher prevalence of cancer in people with PMR during a 40-week follow-up. There is no single test for PMR, which can make diagnosis a challenge. Instead, doctors will begin by:
The next stage of diagnosis may involve blood tests to rule out other conditions, such as lupus and RA. These tests may include:
CRP and ESR tests check for inflammation in the body, which can be a sign of PMR. If both the ESR and CRP are normal, a doctor is unlikely to diagnose PMR. However, some people with PMR have normal or only slightly raised levels of both. A doctor may also use ultrasound or MRI scan to check for bursitis, which is inflammation around the joints. If a person could have giant cell arteritis, the doctor will also examine arteries to see if they are inflamed or tender or have a reduced pulse. They may take a small tissue sample to confirm the diagnosis, but this is not always necessary. Learn about the treatments for PMR. Some questions people might want to ask a doctor about the process of diagnosing PMR include:
PMR causes widespread pain and stiffness around the joints, particularly larger joints, such as the shoulders. It also causes fever, fatigue, appetite loss, and weight loss. These symptoms can be similar to those of other diseases, including RA, lupus, Lyme disease, and fibromyalgia. A person with symptoms of PMR, or diseases that can mimic PMR, should speak with a doctor. This is especially important if they may have had a recent tick bite or show signs of giant cell arteritis. Early treatment can make PMR, as well as other similar conditions, easier to manage. Is polymyalgia rheumatica the same as rheumatism?Polymyalgia rheumatica (PMR) is considered the most frequent inflammatory rheumatic disease in the elderly. Its highest prevalence is between 70–80 years of age, with a slow increase until the age of 90 years.
What diseases can mimic polymyalgia rheumatica?Some other illnesses that may be confused with polymyalgia rheumatica include:. Rheumatoid arthritis.. Infections.. Inflammation of blood vessels (vasculitis). Chemical and hormonal abnormalities.. A variety of muscle diseases.. Cancer.. What can make polymyalgia rheumatica worse?Increased weight puts more pressure on the muscles and joints affected by PMR, which can make your pain worse. Some people may be intolerant to gluten, the protein found in wheat, barley, and rye. Excessive sugar intake is also inflammatory and may cause weight gain.
What does the pain of polymyalgia feel like?Aches or pain in your shoulders. Aches or pain in your neck, upper arms, buttocks, hips or thighs. Stiffness in affected areas, particularly in the morning or after being inactive for a time. Limited range of motion in affected areas.
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