How Polymyalgia Rheumatica Is Diagnosed

Diagnosis of polymyalgia rheumatica (PMR) is accurately done by a rheumatologist. Physical examination, ESR and CRP tests, CBC, ultrasound, and biopsy help confirm PMR.

Diagnosing a patient with polymyalgia can be a bit complicated. The reason is that symptoms of polymyalgia are also manifested in other immune diseases. A couple of tests and imaging may be required to accurately diagnose this rare autoimmune disease.

People with chronic pain try to find a cure for their illness. They resort to natural remedies and other forms of treatment. Many times, the pain does not go away and those patients with unbearable pain attack are frustrated.

Speak with a Rheumatologist

Who is the best doctor to help you relieve your symptoms of PMR? A rheumatologist is a medical specialist who performs polymyalgia rheumatica or PMR diagnosis. He will conduct a general physical exam to determine the cause of your stiffness and pain.

The physical exam will give your rheumy an idea of your total health condition. He can also rule out other diseases with similar symptoms. You will be subjected to blood tests to determine indicators of inflammation.

An erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) tests are used as inflammation markers. Your rheumatologist will check these values and assess your complete blood count (CBC). These tests are required before he can provide a polymalgia rheumatica diagnosis.

Symptoms of Polymyalgia Rheumatica

When do you see a rheumatologist? When you start experiencing the symptoms of PMR, such as muscle pain and stiffness felt in the arms, neck, shoulders, and hips, it is time to see a rheumatologist. If you are above 50 and experiencing these symptoms, you do not have to suffer the chronic pain every day. You need treatment immediately. Elderly people are especially uncomfortable with pains. Watch out for other symptoms like fatigue, low fever, loss of appetite, limited range of motion and malaise.

Symptoms of PMR develop quickly over a few days but may also appear overnight. The pain and stiffness may be tolerable to severe. The discomfort prevents the patient from performing even simple daily activities. PMR can even make it difficult for you to sleep. Seeking medical attention is immediately required.

PMR symptoms peak in the morning but gradually taper off the rest of the day. They worsen when you are inactive or you stay in just one position for long hours. Women are most likely to suffer from PMR than men. Some people with PMR can also be diagnosed with giant cell temporal arthritis. This causes jaw pain, vision difficulties, and headaches. These symptoms are a result of inflammation of blood vessels in the arms, neck, and scalp.

Physical Examination and Blood Tests

PMR diagnosis by a rheumatologist
A rheumatologist accurately diagnoses a patient with PMR after blood tests and imaging confirms inflammation through ESR and CRP tests (image from medicalnewstoday.com)

Your rheumy will let you move your arms, neck, and legs during the physical examination. This is to evaluate your range of mobility. The doctor may also recommend an ultrasound to determine the presence of inflammation in tissues and joints. High-frequency sound waves generated during an ultrasound form detailed images of the different soft tissues. The detailed images help distinguish PMR from other illnesses with the same symptoms.

A rheumatologist accurately diagnoses a patient with PMR after blood tests and imaging confirms inflammation through ESR and CRP tests (image from medicalnewstoday.com)

He may also perform a biopsy due to the link between PMR and giant cell arteritis (GCA). A biopsy is needed for suspected inflammation in the blood vessels. A biopsy is a simple and low-risk procedure. A small part of the tissue is removed as a sample from the temple artery of the patient. The sample is analyzed in a medical laboratory to determine the presence of inflammation in it.

Polymyalgia rheumatica diagnosis should be done comprehensively. This is to rule out symptoms similar to other inflammatory conditions like arthritis and lupus.

Anti Inflammatory Drugs for PMR

There is no cure for PMR. The diagnosis of PMR will allow the doctor to prescribe treatment to reduce inflammation. Corticosteroids are the most-prescribed anti-inflammatory drug for PMR. Corticosteroids like prednisone are effective but they also have side effects. Some over-the-counter pain relievers are not as effective in treating PMR symptoms.

Together with prednisone, your rheumatologist will recommend daily calcium and vitamin D supplements to counter side effects of steroids.

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