Polymyalgia Rheumatica

Question 1

what is polymyalgia rheumatica

Answer 1

polymyalgia rheumatica is an inflammatory condition with unknown cause

Question 2

it exclusively occurs in patients above what age

Answer 2

50

Question 3

what is polymyalgia rheumatica characterised by

Answer 3

severe bilateral pain, morning stiffness of the shoulder, neck and pelvic girdle

Question 4

does polymyalgia cause weakness

Answer 4

no; just pain and stiffness

Question 5

what causes polymyalgia rheumatica

Answer 5

aetiology unknown

associated with temporal arteritis

Question 6

diagnostic criteria of polymyalgia rheumatica

Answer 6

age above 50,

duration of symptoms >2 weeks

bilateral shoulder/ pelvic girdle/ neck pain

morning stiffness

high ESR and CRP

Question 7

presenyting symptoms of polymyalgia rheumatica

Answer 7

morning stiffness,

bilateral shoulder/neck/pelvic girdle pain

symptoms worse on activity

flu-like symptoms

Question 8

main differentiating point from other rheum/Msk conditions

Answer 8

in polymyalgia rheumatica, there is NO weakness

Question 9

investigations

Answer 9

bloods- FBC, CRP, ESR, U&Es, LFTs, bone profile, TFTs

CRP raised due to inflammatory nature of polymyalgia rheumatica

Question 10

management of polymyalgia rheumatica

Answer 10

corticosteroids

physiotherapy and occupational therapy

monitor for adverse effects of long term steroid use

Question 11

what are some side effects of long term steroid use

Answer 11

skin thinning, easy bruising and tearing, slow wound healing

osteoporosis

stomach ulcers

high blood pressure (hypertension)

Question 12

complications of polymyalgia rheumatica

Answer 12

temporal arteritis

relapse

complications of steroid use - may increase risk of fracture