Differenzialdiagnose der Polymyalgia rheumatica (PMR) und der Riesenzell-Arteriitis (RZA)

Zusammenfassung

Die Differenzialdiagnose der Polymyalgia rheumatica (PMR) und der Riesenzellarteriitis (RZA) ist vielfältig. Da beide Entitäten das höhere Lebensalter betreffen, sind verschleißbedingte Symptome des Schultergürtels, aber auch projizierte Schmerzen bei chronisch-ischämischer Herzkrankheit sowie Tumorerkrankungen in die differenzialdiagnostischen Überlegungen einzubeziehen. Auch die Inzidenz neurologisch-psychiatrischer Krankheiten wie der M. Parkinson oder Depressionen – beide sind als Ursachen chronischer Schmerzen bekannt – steigt altersbedingt an. Medikamenten-Nebenwirkungen können ebenso Auslöser von Myalgien sein wie (v. a. virale) Infektionen. Bei letzteren steigen zusätzlich die Akut-Phase-Parameter an, sodass Virusinfekte zu PMR-ähnlichen Konstellationen führen können.

Abstract

Both polymyalgia rheumatica and giant cell arteritis possess a multifaceted differential diagnosis. Since both entities are typical diseases of the elderly, degenerative disorders of the musculoskeletal system as well as ischemic heart disease and malignancies have to be taken into account. The incidence of neuropsychiatric diagnoses such as Parkinson’s disease and depression is rising with age as well. Both conditions are known to cause chronic and widespread musculoskeletal pain. Drug induced side effects can mimic polymyalgia rheumatica as well as infections, the latter also leading to increased acute phase parameters.··

Schlüsselwörter

Polymyalgia rheumatica - Arteriitis temporalis - Riesenzellarteriitis - Differentialdiagnose

Key words

polymyalgia rheumatica - temporal arteritis - giant cell arteritis - differential diagnosis

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