Polymyalgia Rheumatica

Question 1

What is polymyalgia rheumatica?

Answer 1

Inflammatory condition with unknown aetiology

Question 2

What is polymyalgia rheumatica associated with and who does it most commonly affect?

Answer 2

Women over 50, associated with giant cell arteritis (10-20% have it)

Question 3

What is the presentation of polymyalgia rheumatica?

Answer 3

Signs:
- Rapid onset of symptoms with bilateral distribution
- Proximal limb girdle pain (shoulders, neck, hips)
- Aching, morning stiffness
Signs of GCA:
- Scalp tender to touch
- Jaw claudication whilst chewing
- Headache
- Sudden visual change (can cause permanent visual loss)
Systemic:
- Lethargy, malaise, depression, B-symptoms

Question 4

Investigations for polymyalgia rheumatica?

Answer 4

Raised ESR/CRP and plasma viscosity

Normal creatinine kinase

Question 5

Management for polymyalgia rheumatica?

Answer 5

Oral prednisolone (produces dramatic response)
Routinely monitor for GCA