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November 1985

Polymyalgia Rheumatica

Arch Intern Med. 1985;145(11):2130. doi:10.1001/archinte.1985.00360110206049

To the Editor.  —I would like to commend Lauter et al1 on their comprehensive and lucid discussion of polymyalgia rheumatica (PMR). In particular, from my experience both as a consulting rheumatologist and as a faculty member instructing medical students, house staff, and primary care physicians, I would underline their description of PMR as a low-grade symmetric synovitis involving primarily large proximal joints. Partially because of its name, house staff and many primary care physicians think of PMR as a muscular disorder, confusing it with fibromyalgia syndrome and polymyositis. Indeed, the patient described by Lauter et al had a positive test for rheumatoid factor; it would be interesting to know if the patient presented at a later date with symmetric small-joint peripheral synovitis of rheumatoid arthritis.My only exception for treatment of PMR (and temporal arteritis) in the article by Lauter et al is "stressing repeated clinical observation and frequent