Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Aug 10;33(36):e241.
doi: 10.3346/jkms.2018.33.e241. eCollection 2018 Sep 3.

Characteristics of Korean Patients with Polymyalgia Rheumatica: a Single Locomotive Pain Clinic Cohort Study

Jong Geol Do  1 , Jinyoung Park  2 , Duk Hyun Sung  3
Affiliations

Characteristics of Korean Patients with Polymyalgia Rheumatica: a Single Locomotive Pain Clinic Cohort Study

Jong Geol Do et al. J Korean Med Sci. .

Abstract

Background: Polymyalgia rheumatica (PMR) is a common systemic inflammatory disease of the elderly; however, the clinical characteristics and therapeutic response of PMR in Korea have been rarely studied.

Methods: We reviewed the medical records of 54 Korean patients diagnosed with PMR between January 2009 and February 2017 in a locomotive pain clinic of one tertiary referral hospital. We analyzed epidemiologic and clinical characteristics, therapeutic responses, and prognostic factors for remission-failure at one-year after oral prednisolone treatment.

Results: In 54 patients with PMR, 32 (59.3%) were female. The average age at diagnosis was 65.0 ± 10.5 years. Duration of symptoms before diagnosis was 8.1 ± 8.6 months. All patients had shoulder pain (54 patients, 100.0%); 49 patients (90.7%) had hip girdle pain, while 19 patients (35.2%) had peripheral joint pain. Four patients (7.4%) were accompanied by the giant cell arteritis (GCA). There was no seasonal preference for symptom development. Only 19 patients were diagnosed with PMR at initial symptom presentation. At one-year follow-up after oral prednisolone treatment, the remission rate was 35.3% (12/34). Multivariate analysis showed that history of relapse (odds ratio, 6.81; 95% confidence interval, 1.035-44.804) was a significant predictor of remission-failure.

Conclusion: The rate of remission (35.3%) after oral prednisolone treatment was similar to previous reports in western countries; and GCA is not a rare condition in Korean PMR patients. Misdiagnosis of PMR is common, and heightened consideration for PMR is needed in elderly patients who present inflammatory features of bilateral shoulder pain.

Keywords: Giant Cell Arteritis; Polymyalgia Rheumatica; Prednisolone; Treatment Outcome.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. 18F FDG-PET/CT and CT angiography findings of a 56-year-old female diagnosed with GCA. Coronal FDG-PET/CT (A) image demonstrates a significant uptake in aortic wall from the level of thoracic spine to aortic bifurcation (black arrows). Uptake of the tracer of the bilateral glenohumeral joints, bilateral greater trochanter area and left acromio-clavicle joint is also seen (black arrowheads). CT angiography image (B) and (C) shows the diffuse thickening with enhancement in thoracic aorta and abdominal aorta (white arrows).
FDG-PET/CT = fluorodeoxyglucose positron emission tomography/computed tomography, CT = computed tomography, GCA = giant cell arteritis.
See this image and copyright information in PMC

References

    1. Barber HS. Myalgic syndrome with constitutional effects; polymyalgia rheumatica. Ann Rheum Dis. 1957;16(2):230–237. - PMC - PubMed
    1. Owen CE, Buchanan RR, Hoi A. Recent advances in polymyalgia rheumatica. Intern Med J. 2015;45(11):1102–1108. - PubMed
    1. Pipitone N, Salvarani C. Update on polymyalgia rheumatica. Eur J Intern Med. 2013;24(7):583–589. - PubMed
    1. Soriano A, Landolfi R, Manna R. Polymyalgia rheumatica in 2011. Best Pract Res Clin Rheumatol. 2012;26(1):91–104. - PubMed
    1. Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C, et al. 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis. 2012;71(4):484–492. - PMC - PubMed