Polymyalgia rheumatica — understanding and treatment (3D)
About this app
A BodyParts3D skeleton with the bursae, tendon sheaths and joint linings that become inflamed at the shoulder and hip girdle. Five stations: onset via IL-6 and CRP, symptoms over the day with raising the arms and standing up, the painful arc beneath the shoulder roof, cortisone tapering with relapse, walking afterwards. Plus the warning signs of giant cell arteritis.
With explain mode: an AI tutor walks you through the app, points out what matters in the scene and answers your questions.
What happens in PMR
Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatic disease of older age; it almost only begins after 50. Within days to a few weeks both shoulders start to hurt, often the hips and neck too, worst in the morning. Inflammation mainly affects bursae, tendon sheaths and joint linings; the muscles themselves stay healthy. The messenger IL-6 from the inflamed tissue prompts the liver to make CRP, which is why inflammation markers in the blood rise. Low-dose cortisone usually relieves the symptoms within a few days.
What the app shows
A BodyParts3D skeleton with simplified bursae, the sheath of the long biceps tendon, the joint linings of shoulder and hip, the liver and the temporal artery. Five stations lead through the disease: onset with IL-6 and CRP as visible particle streams, symptoms over the day with raising the arms and standing up, a look inside shoulder, hip and spine, the course on prednisolone and walking afterwards. A separate panel lists the warning signs of giant cell arteritis. All curves are schematic.
Things to try
Drag the time of day and see why mornings are hardest: IL-6 peaks at night, and the body’s own cortisol comes too late. In the station “Inside”, raise the arm degree by degree and find the painful arc. In treatment, follow week by week how pain and CRP fall while the dose is slowly reduced, optionally with a relapse.
Frequently asked questions
- What is polymyalgia rheumatica?
- Polymyalgia rheumatica is an inflammatory rheumatic disease that almost only affects people over 50, usually around 70, women two to three times as often as men. Typical are pain and stiffness on both sides of the shoulder and hip girdle, lasting more than 45 minutes in the morning, together with raised inflammation markers in the blood. The exact cause is unknown.
- Why are the symptoms worst in the morning?
- In people with PMR the messenger IL-6 peaks in the second half of the night. The body’s own cortisol, which damps inflammation, only rises towards morning and so comes too late. This is one explanation for the marked morning stiffness.
- How is polymyalgia rheumatica treated?
- The standard is a glucocorticoid such as prednisolone at a low dose, usually 12.5 to 25 mg a day to start. Symptoms often improve within a few days. The dose is then reduced slowly over months; many people can stop cortisone after one to three years. Dose and pace are set by the doctor, and cortisone must never be stopped on your own.
- How is PMR related to giant cell arteritis?
- In about one in five to six people with PMR, large arteries become inflamed as well, often the temporal artery. Warning signs are new headaches at the temple, jaw pain when chewing and visual problems. These need medical help the same day, and visual problems need the emergency department at once, because blindness can follow.
Subject: Biology & neuroscience
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