In life, we often meet such middle-aged and elderly people, they always feel all over the body, either here or there pain, but to the hospital examination, and can not find out what the disease. Indeed, especially in the rheumatism specialist clinic, this situation is very common in the middle-aged and elderly patients. They wake up in the morning with generalized aches and pains, muscle and joint stiffness and pain, but it is often difficult to point out a specific joint pain, but also can not say when the pain began, mainly in the neck, shoulders and back to the upper arm, around the pelvis to the thighs of the soreness, get up and move around, but not so painful. Suspect rheumatoid arthritis? Or osteoporosis? Or any other rheumatic disease? However, after taking X-ray and checking rheumatoid factor, no abnormality was found. After a detailed history and relevant tests, rheumatoid arthritis, antinuclear antibody-related connective tissue disease, tumors and chronic infections (especially tuberculosis) were also ruled out, followed by osteoporosis and osteoarthritis. Laboratory tests seem to be all over the place, with only elevated blood sedimentation and C-reactive protein. A significant number of these patients end up being diagnosed with rheumatic polymyalgia. So what is rheumatic polymyalgia? Rheumatic polymyalgia is very common abroad and is a common disease in western countries. However, in China, not only the common people do not know much about it, even the clinicians do not know enough about it, in fact, in China, the number of elderly people with the disease is quite a lot, in the last decade or so, China’s rheumatologists began to pay attention to rheumatic polymyalgia, and other specialists in this disease is still unfamiliar to the doctors. Rheumatic polymyalgia, due to the non-specificity of clinical symptoms and the lack of diagnostic laboratory indicators, its symptoms are often clinically interpreted as osteoporosis or “geriatric rheumatic pain”, and many patients are even delayed in the diagnosis for many years, suffering in pain until the gradual decline in physical ability, inability to walk and take care of themselves, and finally Many patients are even delayed in diagnosis for many years, suffering in pain until they gradually lose their physical ability, cannot walk and take care of themselves, and finally become bedridden and finish their life, which is interpreted as “dying of old age”. If detected at an early stage and once diagnosed, most people do not need to be hospitalized, but only need to adhere to the outpatient medication, and the improvement of symptoms is very obvious. In addition to relieving pain, the treatment is more important to prevent the disease from leading to “gradual physical decline and death from old age”, thus prolonging the life span of the elderly. Rheumatic polymyalgia mainly occurs in the elderly over 60 years of age, a small number of more than 50 years of age onset of the disease, the older the prevalence of the higher, the average age of 70 years old, women accounted for the majority of men and women for the ratio of 1:2 ~ 4. At present, rheumatic polymyalgia, the etiology and pathogenesis of rheumatic polymyalgia is still not clear. Its etiology may be multifactorial, leading to immune inflammation through immune mechanisms under the combined effect of intrinsic factors and environment. Therefore, its most important feature is the increase in blood sedimentation and C-reactive protein, which reflect the body’s inflammatory response. Patients often complain of a lot of generalized pain and discomfort, starting with the neck and shoulders, then developing to the proximal limbs, neck, chest, buttocks and other parts of the body, sometimes the distal muscles and joints can also be involved, which directly affects the patient’s life. Stiffness is evident in the morning or after a sedentary break when starting to move again. Morning stiffness can be manifested as going to bed in the evening and waking up in the morning with generalized pain and stiffness, and the duration of morning stiffness can be as light as half an hour, or as heavy as several hours, or even the whole day without relief. Muscle weakness starts with pelvic girdle muscles and thighs, and gradually develops to generalized muscle weakness. In severe cases, daily activities are limited, combing hair, shaving, dressing, squatting, going up and down stairs are difficult, even turning over in bed and sitting up are difficult, and muscle atrophy may occur to further aggravate the muscle weakness phenomenon. Some patients may show fluctuating remissions alternating with relapses. Although patients with rheumatic polymyalgia have a lot of complaints and severe symptoms, there are few positive signs on physical examination, presenting a typical symptom-sign mismatch. Laboratory tests only show non-specific inflammatory markers (sedimentation, C-reactive protein, etc.) to be elevated. Therefore, the diagnosis relies solely on the characteristics of the clinical presentation and the clinician’s perception. Diagnostic points and treatment concepts of rheumatic polymyalgia Treatment is mainly to alleviate symptoms, stop the progression of lesions, and prevent damage to vital organ functions. With appropriate treatment, rheumatic polymyalgia can be rapidly controlled, relieved or cured; it can also be prolonged or recurring; and in the later stages of the disease, serious conditions such as muscular wasting atrophy or shoulder capsule contracture can also occur. If rheumatic polymyalgia is not associated with giant cell arteritis, the prognosis is better. Therefore, the treatment of rheumatic polymyalgia can be relatively conservative, and the drug can be stopped within 2 years.