Polymyalgia Rheumatica

Question 1

Features of PMR

Answer 1

Age > 50
Bilateral shoulder aching
Elevated ESR and CRP
Morning stiffness > 45 minutes

Question 2

Pharmacological management of PMR

Answer 2

Prednisolone 15mg PO OD for 4 weeks then taper. Continue for at least 9 months but typically will require longer than 12 months

Question 3

Complications of untreated PMR

Answer 3

Giant Cell Arteritis
Chronic Pain Syndrome
Depression
Stroke

Question 4

Signs of Giant Cell Arteritis

Answer 4

Jaw claudication
Severe headache localised to temple
Scalp tenderness
Weight loss, fever, malaise, general pain

Question 5

Management of GCA

Answer 5

Prednisolone 50mg PO Daily for minimum 4 week then taper

Evolving visual loss? Methylprednisolone sodium succinate 1g IVIF over 1 hour daily for 3 days, then switch to oral use.

Aspirin 100mg PO Daily to prevent ischaemic events.