Polymyalgia Rheumatica
An inflammatory disorder of the shoulder and hip girdle synovium and periarticular structures in older adults, producing bilateral proximal pain and stiffness that resolves dramatically with corticosteroids, and closely linked to giant cell arteritis.
First principles
Polymyalgia rheumatica targets periarticular structures around the girdles, not the joints themselves
Polymyalgia rheumatica is driven by inflammation of the synovium, bursae and tendon sheaths around the shoulder and hip girdles, mediated by activated T cells and pro-inflammatory cytokines (notably IL-6) in an older population, rather than by an autoantibody-driven synovitis of the small joints as in rheumatoid arthritis. Because the inflammation is periarticular and proximal, patients describe pain and stiffness in the shoulders, neck and hips rather than swelling of individual small joints, and true synovitis is often subtle or absent on examination.
Educational content pending clinical review. Not medical advice.