Eleven (14%( of 80 patients with
polymyalgia rheumatica syndrome (PMR-S) recovered spontaneously within one year; two of them had received repeated
injections of depot
steroids before remission occurred. The remaining 69 patients, including 14 with
giant cell arteritis (GCA), were all treated with systemic
glucocorticoids for an average of 30 months (range 3-81 months). Nine of the patients developed side effects from the treatment, which in seven cases were severe
osteoporosis and spinal compression. None suffered from loss of vision. The patients' mortality rate and causes of death did not differ from those of the population at large. The diagnostic criteria are discussed, with the omission of those applied for exclusion. Use of the common term PMR-S is preferred, as GCA and
polymyalgia rheumatica (PMR) are clinically indistinguishable. Systemic
glucocorticoids are urgently needed when
arteritis or ocular manifestations are detected or even suspected. In uncomplicated cases of PMR we recommend that trials be made with repeated
injections of depot
steroids. This procedure could also be used in patients suffering from severe subjective recurrences after
cessation of treatment with systemic
glucocorticoids, thereby reducing the number of cases where
steroid treatment is unquestionably maintained for too long.