26 - Polymyalgia rheumatica

Question 1

what is PR?

Answer 1

inflammatory condition of elderly

Question 2

what condition is closely linked to PR?

Answer 2

Giant cell arteritis

Question 3

who is affected?

Answer 3

F>M (2:1), rarely under 50 yrs - usually 70+ years

Question 4

how does PR present?

Answer 4

old woman with sudden onset of shoulder +/- pelvic girdle stiffness

Question 5

ESR result?

Answer 5

usually >45 (often ~100)

Question 6

which condition of the blood do patients of PR often suffer?

Answer 6

anaemia

Question 7

name 4 systemic symptoms associated?

Answer 7

malaise, weight loss, fever, depression

Question 8

rheumatology symptoms?

Answer 8

arthralgia/ synovitis

Question 9

what information is needed to make diagnosis? (3)

Answer 9

age >50, ESR >50, dramatic response to steroids

Question 10

name 4 differentials?

Answer 10

myalgic onset inflammatory joint disease, malignancy, hypo/hyper-thyroidism, fibromyalgia

Question 11

name 2 malignancies which are commonly associated with PR?

Answer 11

multiple myeloma, lung cancers

Question 12

management?

Answer 12

prednisolone 15mg daily for 18-24 month course

Question 13

prophylaxis?

Answer 13

bone prophylaxis