Polymyalgia rheumatica – die häufigste Muskelerkrankung im Alter

Zusammenfassung

Die Polymyalgia rheumatica (PMR) ist eine häufige, chronische, entzündlich rheumatische Erkrankung unklarer Ätiologie, die typischerweise Patienten ab dem 50. Lebensjahr betrifft. Neben der klinischen Diagnostik unterstützen moderne bildgebende Verfahren, wie die Sonografie und die Magnetresonanztomografie mit Nachweis einer bilateralen Bursitis subdeltoidea/-acromialis, Tenosynovitis der Bizepssehnen und/oder Synovitis der Schultergelenke die korrekte Diagnosestellung auch in klinisch schwierigen Fällen. Kortikosteroide sind die Medikamente der Wahl in der Behandlung der PMR, führen jedoch bei mehr als 50 Prozent der behandelten Patienten zu Nebenwirkungen. Ob Immunsuppressiva wie Methotrexat oder Biologika in der Behandlung der PMR effektiv sind, ist derzeit nicht geklärt.

Summary

Polymyalgia rheumatica (PMR) is a common chronic inflammatory disease with unknown aetiology, affecting predominately people of middle age and older. Besides clinical symptoms and laboratory signs, imaging techniques including sonography and magnetic resonance imaging may provide evidence of typical inflammatory lesions with bilateral bursitis subdeltoidea/-acromialis, tenosynovitis of the biceps` tendon sheath and/or synovitis of the shoulder joints and thus may support the diagnosis of this disease in difficult cases. Up to now, corticosteroids are the cornerstone of treatment of PMR. Adverse events because of chronic corticosteroid use are observed in more than 50 % of treated patients. Whether the use of immunosuppressants such as methotrexate or biologicals is effective in the therapy of PMR, remains elusive so far.

Schlüsselwörter

Polymyalgia rheumatica - Klassifikationskriterien - Sonografie - Magnetresonanztomografie - Therapie

Keywords

Polymyalgia rheumatica - classification criteria - ultrasound - magnetic resonance imaging

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