Distal musculo-skeletal manifestations in rheumatic polymyalgia

The frequency and characteristics of distal musculo-skeletal manifestations (DMM) are reported in a series of 136 patients with the diagnosis of rheumatic polymyalgia (RPM). Thirty-eight patients (28%) had DMM concomitantly with the diagnosis of RPM or during its course. Peripheral arthritis were most common, and 40 episodes were identified in 31 patients. Eight patients had the typical manifestations of the pitting edema. Tenosynovitis was observed in four patients and the carpal tunnel syndrome in three. Five patients had 2 DMM manifestations associated. In 80% of cases the detection of DMM occurred at diagnosis, and were associated with the characteristic proximal symptoms in RPM. The response to corticosteroid therapy was favorable in all cases. The eight patients with pitting edema had an ESR lower at diagnosis and a shorter total length of treatment of RPM.