Polimialgia reumática: ¿pensamos en ella?

Polymyalgia rheumatica (PMR) is a chronic inflammatory disease which is generally diagnosed in primary care in patients older than 50 years. The diagnosis is based on clinical findings, analytical tests and the response to corticoids. Clinical findings are symmetrical pain and stiffness affecting shoulders, hips and cervical spine. There are several diagnostic criteria of PMR, with Bird́s Criteria being the most sensitive. PMR differential diagnosis is made with rheumatic, infectious, autoimmune and osteoarticular diseases. There is a special interest in the relationship between PMR and giant cell arteritis as this association is not uncommon. The treatment of choice for PMR is corticoid therapy, showing a sharp clinical improvement, but its maintenance period is unknown, and should be determined empirically. Some studies show that other immunomodulatory drugs, such as methotrexate and infliximab can be added to reduce the length of the corticoid treatment.