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CD-ROM Today (UK) (Spanish) 15
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1994-01-17
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$Unique_ID{BRK02059}
$Pretitle{}
$Title{Diagnosing and Treating Polymyalgia Rheumatica}
$Subject{polymyalgia rheumatica arthritis pain cortisone shoulder shoulders
hip hips joint aches ill stiff muscle muscles fever weight loss rheumatoid
arthritis elevated sedimentation rate ESR corticosteroids prednisone aging}
$Volume{}
$Log{}
Copyright (c) 1993 Tribune Media Services, Inc.
Diagnosing and Treating Polymyalgia Rheumatica
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QUESTION: After months suffering with a pain across her shoulders, my wife
finally visited her doctor. What we both thought was simply a case of old age
arthritis (she is now 73) was diagnosed as "polymyalgia rheumatica", a disease
we have never heard about. The doctor wants to use cortisone, or some
medication like that, but we are just a bit fearful. Could you please include
a description of this disease and its treatment in your column?
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ANSWER: Despite the fact that this is the first time you have heard about
this disease, it is not an uncommon one. In people aged 70 to 79 years, it
may be seen in as many as 112 people for every 100,000 population. More
common in women than in men, it is rarely seen before the age of 50, and is
often mistaken for arthritis. The pain usually starts either in the shoulder
or hips, and these muscle and joint aches may last for months. The patient
feels generally ill, stiff upon awakening, often with a fever. In some cases
there is a weight loss as well. Occasional the pattern of joints that are
affected greatly resembles the picture seen in rheumatoid arthritis. However
x-rays of the joints are usually normal.
About the only test that may help a doctor make the diagnosis is an
elevated sedimentation rate (ESR), so a good history and physical is most
important in arriving at the correct conclusion. The cause of this disease
remains unknown, but the treatment is, and general consensus among medical
experts agree that corticosteroids are the treatment of choice. Usually a
dose of from 10 to 20 mg of prednisone daily is prescribed, and treatment may
have to continue for more than 2 years. The good news is that, in most cases,
the symptoms begin to disappear within a few days after treatment starts. The
ESR also returns to normal, and the amount of medication can then be gradually
reduced for as long as the symptoms do not return. Although relapses may
occur, the treatment allows for return to a normal life style and a normal
life expectancy. It seems apparent that your doctor has the right approach to
this disease, and you should continue to follow his advice.
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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician. Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.