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Edited By: Gregory C. Gardner, M.D.Last updated Friday, January 07, 2005
Pathophysiology
PMR is a systemic inflammatory illness that does not actually involve the muscles in spite of the name.
It is actually a synovitis of the large proximal joints although more distal joints can also be involved. Bone scans, arthroscopy, magnetic resonance scans (MRI), and synovial biopsy have all documented the synovial nature of the illness. Open biopsy of the shoulder in patients with PMR has revealed the wide spread involvement of the periarticular synovial tissues such as bursa as well as the joint (6). MRI scans document that the bursae about the shoulder are also frequently involved (7). These data suggest a mechanism for some of the mechanical type symptoms these patients can manifest.
Surgery for arthritis at the University of Washington, Department of Orthopaedics and Sports Medicine, Seattle, Washington
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