Polymyalgia Rheumatica

Question 1

What is Polymyalgia rheumatica (PMR)?

Answer 1

Relatively common condition seen in older people characterised by muscle stiffness and raised inflammatory markers. Whilst it appears to be closely related to temporal arteritis the underlying cause is not fully understood and it does not appear to be a vasculitic process.

Question 2

What are the features of Polymyalgia rheumatica (PMR)?

Answer 2

*typically patient > 60 years old
*usually rapid onset (e.g. < 1 month)
*aching, morning stiffness in proximal limb muscles
»weakness is not considered a symptom of polymyalgia rheumatica
*also mild polyarthralgia, lethargy, depression, low-grade fever, anorexia, night sweats

Question 3

What investigations are used to identify Polymyalgia rheumatica?

Answer 3

• raised inflammatory markers e.g. ESR > 40 mm/hr

* note creatine kinase and EMG normal

Question 4

What is the treatment of polymyalgia rheumatica?

Answer 4

prednisolone e.g. 15mg/od