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Lordosis, kyphosis, and scoliosis
Osteomalacia and rickets
Paget disease of bone
Calcium pyrophosphate deposition disease (pseudogout)
Juvenile idiopathic arthritis
Inclusion body myopathy
Degenerative disc disease
Spinal disc herniation
Achilles tendon rupture
Anterior cruciate ligament injury
Iliotibial band syndrome
Patellar tendon rupture
Patellofemoral pain syndrome
Carpal tunnel syndrome
Thoracic outlet syndrome
Radial head subluxation (Nursemaid elbow)
Rotator cuff tear
Lambert-Eaton myasthenic syndrome
Limited systemic sclerosis (CREST syndrome)
Mixed connective tissue disease
Systemic lupus erythematosus
Developmental dysplasia of the hip
Osgood-Schlatter disease (traction apophysitis)
Slipped capital femoral epiphysis
Back pain: Pathology review
Bone disorders: Pathology review
Bone tumors: Pathology review
Gout and pseudogout: Pathology review
Muscular dystrophies and mitochondrial myopathies: Pathology review
Myalgias and myositis: Pathology review
Neuromuscular junction disorders: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Rheumatoid arthritis and osteoarthritis: Pathology review
Scleroderma: Pathology review
Seronegative and septic arthritis: Pathology review
Sjogren syndrome: Pathology review
Systemic lupus erythematosus (SLE): Pathology review
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Classic Presentation of Polymyalgia Rheumatica (PMR)
for polymyalgia rheumatica p. 477
associations p. 733
ESR in p. 210
giant cell arteritis and p. 478
polymyalgia rheumatica p. 477
With polymyalgia rheumatica, “poly-“ means many, “mya-” means muscles, and “-algia” means pain.
“Rheumatica” comes from rheumatism, which broadly refers to conditions that affect the joints and connective tissue.
So, polymyalgia rheumatica is a disorder that causes muscle pain and joint stiffness.
It is considered to be an immune- mediated disease, meaning that the immune system attacks our own body.
It is important to note that although “myalgia” means muscle pain, the muscles are usually spared and it's the tissue around the joints that mostly gets inflamed.
Normally, the cells of the immune system are always hanging around, ready and excited to spot and fight against anything foreign that could cause harm inside the body.
One particular type of immune cell - the dendritic cell - is a type of antigen-presenting cell, meaning that it grabs a pathogen for example a bacteria, destroys it, and presents a part of that bacteria, called an antigen, to other immune cells.
Dendritic cells take their name from the fact that they have branch like arms called dendrites which help them grab antigen.
Dendritic cells take their captured antigen and move over to a nearby lymph node, where they present the antigen to a helper T-cell.
Dendritic cells “present” the antigen on a protein called a major histocompatibility complex, or MHC, class II molecule which is on their cell surface.
MHC class II molecules are like a serving platter, which hold the antigen as it gets presented to the helper T-cells.
Once these antigens are recognized as foreign, T-helper cells get activated and start secreting a lot of proinflammatory cytokines, or signalling molecules, that recruit more immune cells, such as macrophages, to the site of inflammation.
Polymyalgia rheumatica (PMR) is an autoimmune disorder that causes inflammation in the muscles and joints, resulting in joint pain and stiffness, usually in the shoulders and hips. Symptoms usually develop in people over the age of 50 and may include fatigue, muscle and joint pain, stiffness, loss of appetite, weight loss, and fever. Treatment of polymyalgia rheumatica focuses on suppressing the immune response, usually with low doses of corticosteroids, such as prednisone. Specific exercises and a healthy diet can also help strengthen the muscles and bones, as well as improve flexibility of the affected joints.
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