Polymyalgia Rheumatica

Question 1

What is polymyalgia rheumatica?

Answer 1

Inflammatory rheumatological syndrome characterised by pain and stiffness of shoulder, hip girdles and neck

Question 2

When does polymyalgia rheumatica usually present?

Answer 2

Ages 70-80

Question 3

Which other disease is polymyalgia rheumatica associated with?

Answer 3

Giant cell arteritis

Question 4

What are the symptoms of polymyalgia rheumatica?

Answer 4

New sudden onset proximal limb pain and stiffness
Difficulty rising from chair or combing hair
Night time pain and morning stiffness
Systemic - fatigue, weight loss, low-grade fever

Question 5

What is found on physical exam in polymyalgia rheumatica?

Answer 5

Decreased range of motion of shoulders, neck and hips
Muscle strength normal
Muscle tenderness

Question 6

How is polymyalgia rheumatica diagnosed?

Answer 6

History and exam and raised inflammatory markers

Question 7

What is the management for polymyalgia rheumatica?

Answer 7

15mg prednisolone daily with dramatic response within 5 days - tapered down slowly
Methotrexate in relapse