Is it correct to attribute the first description of Polymyalgia Rheumatica to Dr. William Bruce?

Abstract

Objective: The first description of Polymyalgia Rheumatica (PMR) is traditionally attributed to Dr. William Bruce. We wondered whether it is correct this attribution. Materials and Methods: We read his original article published in 1888 where he reported on five male patients aged from 60 to 74 years whom he had visited at the Strathpeffer spa in Scotland. Results: All five patients much improved or were completely cured after taking sulphur waters internally, frequent spa baths and thorough massages. To the best of our knowledge, thermal therapies have not been shown to be effective in patients with PMR. In 4 out of 5 Bruce’s patients, exposure to cold temperatures triggered the onset or the worsening of musculoskeletal manifestations. However, there is no constant relation between exposure to cold and onset of PMR in the published literature. Finally, the patient of case III also suffered from manifestations that are completely uncharacteristic for PMR. Conclusions: On reading Bruce’s original article, it is doubtful whether all five cases would correspond to patients that we identify as PMR in everyday clinical practice.

Keywords

• polymyalgia rheumatica
• senile rheumatic gout
• history of medicine
• polymyalgia-like syndromes