Polymyalgia rheumatica

Question 1

Pathophyioslogy of polymyalgia rheumatica?

Answer 1

• Muscle bed vasculitis
• Overlap with temporal arteritis
• Histology shows vasculitis with giant cells
  
  • Skip lesions

Question 2

Features of polymyalgia rheumatica?

Answer 2

• Patient > 60 years old
• Usually rapid onset
• Aching, morning stiffness in proximal limb muscles (not weakness)
• Polyarthralgia, lethargy, depression, anorexia, night sweats

Question 3

Investigations into polymyalgia rheumatica?

Answer 3

• ESR > 40mm/hr
• Creatine kinase and EMG normal

Question 4

Treatment for polymyalgia rheumatica?

Answer 4

• Prednisolone
  
  • Dramatic response