Polymyalgia Rheumatica Flashcards
What is a way to conclude that a patient definitely has polymyalgia rheumatic?
Rapid response to low-dose corticosteroids (e.g., Prednisone, 20 mg/day or less)
What age do individuals usually present with polymyalgia rheumatic?
At LEAST over 50 years old (usually over 70)
Can patients with polymyalgia rheumatic have stiffness lasting more or less than an hour?
stiffness last MORE than an hour
Can patients with polymyalgia rheumatic have morning stiffness lasting more or less than an hour?
morning stiffness lasts MORE than an hour
What is the ESR with polymyalgia rheumatic?
ESR >40mm/hr or higher
What other disease is associated with polymyalgia rheumatica?
Giant cell arteritis
***Can cause visual changes, jaw pain, and scalp tenderness
If a patient calls complaining of visual changes, jaw pain and scalp tenderness what should you do with this patient?
Emergency: immediate high dose of steroids required to prevent blindness
Have them go to the ER!!!
Which medication is used in treatment of PMR?
Low-dose prednisone (e.g., 15–20 mg/day)
Taper to lowest tolerated dose.
What duration does the patient have to stay on the prednisone?
Ideal duration > 1 year
If treatment length is < 1 year, 70% recurrence rate.
If treatment length is > 1 year, 30% recurrence rate.
How do you taper the prednisone with PMR to prevent recurrence?
Begin with 20 mg for 2 months.
Decrease by 5 mg every 2 months until patient reaches 5 mg/day.
Keep patient on 5 mg/day for remainder of a full year.
Then decrease by 1 mg every month until complete.
What medication can be used in combination with prednisone to lessen the amount of prednisone (“steroid sparing”)?
Methotrexate
Which is not a feature of PMR diagnosis?
A. Diagnosis after the age of 50 but usually seen after age 70.
B. Involvement of the hands and feet are important.
C. PMR usually affects the shoulders and the hips.
D. Inflammatory markers are elevated.
B. Involvement of the hands and feet are important.
