Polymyalgia Rheumatica

Question 1

What investigations are used in Polymyalgia Rheumatica?

Answer 1

High ESR > 40 mm/hr
Normal Creatine kinase + EMG

Question 2

What is PMR?

Answer 2

inflammatory rheumatic syndrome in >50s

Question 3

In which group is PMR more common?

Answer 3

> 50s
F > M (3:1)

Question 4

What condition is PMR associated with?

Answer 4

Giant cell arteritis
~10% with PMR also have GCA

Question 5

Describe onset of PMR

Answer 5

Usually rapid (<1 month)

Question 6

What is the key presenting complaint in PMR?

Answer 6

Symmetric pain + morning stiffness in proximal limb muscles (shoulders, neck + pelvic girdle)

Question 7

List 5 systemic symptoms associated with PMR

Answer 7

Lethargy
Depression
Low-grade fever
Anorexia
Night sweats

Question 8

What investigations are performed for PMR?

Answer 8

FBC: normochromic anaemia
Inflammatory markers (CRP + ESR): both raised
Creatine kinase: normal
Autoantibodies: -ve

Question 9

What is treatment for PMR?

Answer 9

Prednisolone e.g. 15mg OD
Typically respond dramatically to steroids, failure to do so should prompt consideration of an alternative dx
Slowly taper + eventually stop