Saturday, November 14, 2015

Most Common Diseases of Ages of 50 Plus - Musculoskeletal disorders (MSDs): Polymalgia Arthritis(PMR): The Diagnosis

Kyle J. Norton(Scholar)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Musculoskeletal disorders (MSDs) is medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints. A shoulder disorderwas found in 27% of subjects, rheumatoid arthritis in 1% and osteoarthritis(OA) of the hand, hip, and knee in five, seven, and 18% of subjects, respectively. Disability was frequent: a walking distance of < 500 m was found in 60% and ADL dependency in 40% of the group. Factors related to one or both of these disability measures included female gender, hip and knee OA, impaired vision, cognitive impairment and neurologicaldisease(1).

                        Polymalgia Arthritis

Polymalgia Arthritis Polymalagia Arthritis is defined as a condition a common inflammatory rheumatic disease which cause pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdleas a result of the presence of a synovitis in proximal joints and periarticular structures, causing musculoskeletal symptoms in PMR.

There is no specific test to diagnose polymyalgia rheumatica. The practice guideline for general practitioners (GPs) on polymyalgia rheumatica and temporal arteritis was published in February 2010 by the Dutch College of General Practitioners. This guideline provides GPs with recommendations for the diagnosis and treatment of polymyalgia rheumatica. After other disorders have been excluded, the diagnosis of ‘polymyalgia rheumatica’ is made in patients over the age of 50 who have bilateral pain in the neck and shouldergirdle and/or hip girdle that has lasted for longer than 4 weeks, morning stiffness that lasts longer than 60 minutes and an ESR > 40 mm in the first hour(22). Other researchers suggested that Diagnosis of rheumatologic disorders in the elderly is often complicated by the primary care clinician’s inability to differentiate among similar manifestations of rheumatologic disorders, the presence of comorbid conditions, and symptoms attributed simply to aging. A major consequence of the aches and pains associated with rheumatologic disorders, including polymyalgia rheumatica (PMR), is the impedance of activities of daily living, potentially leading to a loss of independence. PMR is common in the elderly. Often coexisting with PMR, temporal arteritis can lead to complications, including blindness, stroke, or cardiac sequelae. Timely detection and appropriate treatment of PMR in the elderly may improve quality of life, as well as deter irreversible problems. Patient education also has an important role(23).
If you are suspected to develop Polymalagia Arthritis, after a general physical exam, including the examination of shoulder motion, or swelling of the joints in the wrists, hands, etc., certain tests may be necessary

1. Blood test(24)
a. Erythrocyte sedimentation rate (ESR) is the blood test to exam the red blood cells in a test tube. he higher the ESR value is an indication of inflammation.

b. C-reactive protein (CRP)
Blood test measures the levels of C-reactive protein (CRP) produced by the liver in response to an injury or infection and people with polymyalgia rheumatic.

c. Blood test for thrombocytes
Patient with polymyalgia rheumatica have an unusually high number of thrombocytosis. On the other hand, People with anemic polymyalgia rheumatica have a lower number of red blood cells than normal.

d. Rheumatoid factor (RF)
RF is an antibody, a protein made by the immune system presented in the blood of people with rheumatoid arthritis, but not in the blood of people with polymyalgia rheumatica. 

2. Biopsy
Polymyalgia rheumatica is often associated with giant cell arteritis with biopsy by taking a small sample from the scalp artery in the emporal artery and examined under a microscope in a laboratory. Patients suspected ofgiant cell arteritis or polymyalgia rheumatica are often referred to the otolaryngologist for temporal artery biopsy. These patients may initially present to the otolaryngologist with symptoms referable to the head and neck(25).

3. Etc.

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