What is it about ?
Pseudopolyarthritis rhizomelica is also called polymyalgia rheumatica or muscular rheumatism. It is a chronic rheumatic inflammatory disease. We do not know its origin. It can occur at the same time as giant cell arteritis (temporal arteritis).
Where and how often?
Rhizomelic pseudopolyarthritis affects about 5 in 10,000 people. Of every 100 people who have rhizomelic pseudopolyarthritis, 15 to 30 develop giant cell arteritis. The condition (s) occur after the age of 50, with a peak after age 70. It is three times more common in women than in men.
How to recognize it?
Muscle symptoms are characteristic of pseudopolyarthritis rhizomelica: symmetrical pain and stiffness in the neck, shoulders and upper arms (shoulder girdle) and lower back and thighs (pelvic girdle). Symptoms come on suddenly, and persist for more than 1 month. The pain is worse at night. In the morning, you suffer from stiffness for more than an hour.
In addition to these symptoms, more general complaints can develop such as fatigue, fever, loss of appetite, and weight loss.
How is the diagnosis made?
The doctor will usually base this on your symptoms. When he examines you, he finds that shoulder and hip movements are painful and limited. Palpation of the upper arms and thighs can hurt.
There are abnormalities in the blood (for example, inflammation), but there is no test to confirm the diagnosis.
Symptoms of pseudopolyarthritis rhizomelique may go away on its own.
Because it is sometimes difficult to make the diagnosis, your doctor may suggest a trial cortisone treatment. Rapid improvement provides an additional argument for the diagnosis.
What can you do ?
It is important to be aware of the nature of the disease. It can persist for months or even years and then go away, but it can just as well come back. This can happen spontaneously or after reducing the dose of cortisone. If your symptoms return, see your doctor. If you are taking cortisone for a long time, take enough calcium and vitamin D to preventosteoporosis. Eat at least 4 servings of dairy products per day.
What can your doctor do?
A characteristic rhizomelic pseudopolyarthritis that responds well to treatment can be monitored by the general practitioner.
A high dose of cortisone is the basis of treatment. It usually improves symptoms and blood abnormalities. After 1 month, the dose is gradually reduced to reach the minimum effective dose, to be continued thereafter for at least 3 months. A basic treatment is then continued with a reduced dose for 1.5 to 2 years.
In rhizomelic pseudopolyarthritis without giant cell arteritis, the dose of cortisone is usually lower (about half). Cortisone can cause many side effects, such as increased blood sugar (blood sugar) and bone decalcification (osteoporosis). People with diabetes therefore receive a low dose of cortisone combined with an immunosuppressive drug.
To prevent cortisone-related osteoporosis, your doctor will prescribe calcium and vitamin D and, if necessary, osteoporosis medicine.
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