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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{}
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- Copyright (c) 1993 Tribune Media Services, Inc.
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- 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.
-