Polymyalgia Rheumatica

Question 1

what is pmr

Answer 1

inflammatory condition
manifests as pain and morning stiffness in neck, shoulder, hip girdle

Question 2

presentation of pmr

Answer 2

subacute onset - 2wks
bilateral aching, tenderness and morning stiffness
fever, weight loss, anorexia

NO WEAKNESS

Question 3

ix of pmr

Answer 3

ESR
CRP

both elevated

Question 4

mx of pmr

Answer 4

prednisolong e.g. 15mg od

rapid response to steroids within a week

bone protection as steroids needed for 2y at least

Question 5

when may iv methylprednisolone be used for pmr?

Answer 5

IV methylprednisolone is sometimes used under specialists guidance for exacerbations of pmr

Question 6

how long is long enough for steroids to have an effect in pmr?

Answer 6

2 weeks

Question 7

differentials of pmr?

Answer 7

RA
hypothyroidism
fibromyalgia
polymyositis

Question 8

2nd line mx option for pmr?

Answer 8

methotrexate (but dont switch if there’s no response to steroids bc that means it’s unlikely to be pmr)

Question 9

differentiate between pmr and statin-induced myopathy?

Answer 9

esr - elevated in pmr, normal in SIM