Polymyalgia Rheumatica Flashcards
What are some risk factors for PMR?
Usually only affects those over the age of 50 - average age of diagnosis is 70
Women>men (x2)
More common in Caucasians, especially Scandinavians
Common overlap with temporal arteritis - 50% people with TA also have PMR
What causes PMR?
Autoimmune and inflammatory condition with precise aetiology unknown
People with HLA-DR4 have higher risk
Infection e.g. adenovirus, parvovirus B19, parainfluenza, may precipitate
How does PMR present?
Pain + stiffness: moderate-severe, affecting mainly shoulders and hips, also neck/upper arms/thighs, often onset in the morning then eases over day but may be present all day
Fatigue, malaise, lack of appetite (+ possible weight loss), anaemia
Temporal arteritis - headache, scalp tenderness, jaw/facial pain, visual changes
How do you investigate PMR?
No specific test
ESR + CRP - will be raised
Other things like Ca, Vit D, PTH, FBC, etc will be useful to exclude other causes
Temporal artery biopsy if TA is suspected (but don’t delay treatment)
How do to treat PMR?
Prednisone (glucocorticoid like predinsoLOne) - treatment is frequently greater than one year
If no dramatic improvement after 3 days of 10-20mg OD then reconsider Dx
