Polymyalgia Rheumatica

Question 1

What condition is PMR associated with?

Answer 1

GCA- Temporal Arteritis

Question 2

What are the symptoms of PMR?

Answer 2

Aching, tenderness and morning stiffness in the shoulders hips and proximal limb muscles

General- Fatigue, lethargy, low grade fever

Anorexia and depression

Question 3

What investigations should be done for PMR?

Answer 3

Bloods- ESR (OFten >40), CRP, CK

EMG- Normal (helps to rule out others)

Question 4

What test can help to differentiate PMR from polymyositis?

Answer 4

CK would be elevated for polymyositis where as it would be normal for PMR

EMG will also be normal

Question 5

What is the management for PMR?

Answer 5

Steroids- Prednisolone

Dramatic response is often seen like in GCA.

Steroids can cause osteoporosis so may want to protect against this as they’ll be needed long term

Question 6

What should you advise any patients with PMR?

Answer 6

If they develop any of the features of GCA they should seek urgent medical attention

Unilateral headache, scalp tenderness, jaw claudication, loss of vision