Fibromyalgia & Polymyalgia Rheumatica Flashcards
What is the epidemiology of Fibromyalgia?
Occurs in females more than males
What are some of the risk factors for Fibromyalgia?
Dissatisfaction at work Depression, Anxiety, Stress Overprotective family Lack of support Middle aged Divorced Low income Low educational status
What conditions are associated with Fibromyalgia?
Irritable bowel syndrome
Chronic fatigue syndrome
Chronic headache syndrome
What are some of the features of Fibromyalgia?
Chronic & Widespread muscle pain/tenderness Early morning stiffness Fatigue Poor concentration Sleep disturbance Low mood
What investigations can be done for Fibromyalgia?
FBC, ESR, CRP, CK, TFTs, Ca
Try to rule out organic cause of symptoms
What is the management of Fibromyalgia?
Patient education CBT Graded exercise programmes Amitryptiline Pregabalin
How does Polymyalgia Rheumatica present?
Non specific
Older patients
Female patients
Subacute/acute onset of bilateral, severe and persistent pain in the neck, shoulders and pelvic girdle
Morning stiffness for >45 minutes
Raised ESR/CRP
Systemic symptoms eg lethargy, loss of appetite, wt loss
What are some of the differentials for Polymyalgia Rheumatica?
RA OA SLE Dermatomyositis Infection Fibromyalgia
What investigations can be done in a patient with suspected Polymyalgia Rheumatica?
Raised CRP
FBC - Anaemia of chronic disease may be present
U&Es
LFTs
USS of hips/shoulders - tends to show synovitis
What diseases are associated with Polymyalgia Rheumatica?
Temporal arteritis - Headache, Jaw claudication, Visual disturbance
What is the management of Polymyalgia Rheumatica?
Steroids
NSAIDs are of little value
