PMR Flashcards
What is the diagnostic criteria?
Mandatory
Age >50
Aching both shoulders
Abnormal CRP and ESR
Extra Morning stiffness >45mins Reduced hip ROM Negative RF and CCP Absence of peripheral synovitis Utrasonographic findings
What are the clinical features?
Aching and stiffness around neck, shoulders, and lumbar region
Muscle strength normal however testing limited by pain
Can be associated with depression, fatigue, and wt loss
Which cytokine is central?
IL-6
Which imaging modality is useful?
PET
What is the PMR-activity score made up of?
Morning stiffness, elevated of UL, global physician ax, pain intensity, and CRP
Less <7 = low disease activity
What does of pred should you use?
Low dose - 15mg/day 4 weeks
then reduced by 2.5mg every two weeks
Then 1mg each month to wean
- if relapse - go back to the previous effective dose
Which other agents have been trialle?
Methotrexate
Etanercept (modest benefit only)