Polymyalgia rheumatica

Question 1

What is polymyalgia rheumatica (PMR)?

Answer 1

Polymyalgia rheumatica (PMR) is a relatively common condition seen in older people characterised by muscle stiffness and raised inflammatory markers.

Question 2

What age group is typically affected by PMR?

Answer 2

Typically, patients are over 60 years old.

Question 3

What is the onset duration of PMR symptoms?

Answer 3

PMR usually has a rapid onset, often within less than 1 month.

Question 4

What are the main symptoms of PMR?

Answer 4

Aching, morning stiffness in proximal limb muscles.

Weakness is not considered a symptom of polymyalgia rheumatica.

Question 5

What additional symptoms may be present in PMR?

Answer 5

Mild polyarthralgia, lethargy, depression, low-grade fever, anorexia, and night sweats.

Question 6

What investigations are used to diagnose PMR?

Answer 6

Raised inflammatory markers, e.g., ESR > 40 mm/hr.

Creatine kinase and EMG are typically normal.

Question 7

What is the standard treatment for PMR?

Answer 7

Prednisolone, e.g., 15mg once daily.

Question 8

How do patients typically respond to treatment for PMR?

Answer 8

Patients typically respond dramatically to steroids; failure to do so should prompt consideration of an alternative diagnosis.