Miscellaneous

Question 1

British society for Rheumatology core features of polymyalgia rheumatica [5]

Answer 1

Age >50

Duration >2 weeks

Bilateral shoulder/ muscle ache

Morning stiffness for >45 mins

Acute phase response

Question 2

Polymyalgia rheumatic is heavily associated with which vasculitis?

Answer 2

Giant cell arteritis

Question 3

NICE features for polymyalgia rheumatica

Answer 3

Bilateral shoulder pain
- Radiates to elbow

Bilateral pelvic girdle pain

Pain worse on movement

Pain interfering with sleep

Morning stiffness >45 mins

Question 4

Signs of polymyalgia rheumatica

Answer 4

Muscle stiffness
- Pelvic girdle, shoulder muscles, neck

Normal muscle power, sensation, co-ordination and reflexes

Carpal tunnel syndrome

Pitting oedema

Question 5

Blood test findings for polymyalgia rheumatica

Answer 5

Anaemia of chronic disease

Elevated CRP and ESR

Normal :
- CK (myositis)
- Anti-CCP, ANA and RF (RA, SLE)
- TFTs
- Calcium

Question 6

First line therapy for polymyalgia rheumatica

Answer 6

Oral prednisolone 15mg/day
- Taper gradually by 2.5mg, then 1mg)

Co-prescribe vit-D / bisphosphonate/ calcium for bone protection

Question 7

Patients with polymyalgia rheumatic tend to respond to steroids within…

Answer 7

24-72 hours

Question 8

How long are corticosteroids typically continued for in PMR?

Answer 8

1-2 years