Polymyalgia Rheumatica

Question 1

What is polymyalgia rheumatica and where does it normally affect?

Answer 1

Inflammatory condition causing pain and stiffness in the shoulder, pelvic girdle, and neck.

Question 2

Which condition is polymyalgia rheumatica strongly associated with and what do they respond well to?

Answer 2

Giant cell arteritis, steroids.

Question 3

What is this a presentation of?
White female over 50, bilateral shoulder and pelvis pain, worse with movement and interferes with sleep, morning stiffness for 45 mins, systemic symptoms.

Answer 3

Polymyalgia rheumatica

Question 4

What are the main differential diagnoses for polymyalgia rheumatica?

Answer 4

Osteoarthritis, RA, SLE, myositis, cervical spondylosis, adhesive capsulitis, thyroid issues, osteomalacia, fibromyalgia.

Question 5

How is polymyalgia rheumatica diagnosed?

Answer 5

Clinical presentation, response to steroids, inflammatory markers raised, also rule out differentials.

Question 6

What is the treatment for polymyalgia rheumatica and what would you do after a 1 week if there is/isn’t improvement?

Answer 6

1. 15mg prednisolone PO OD
2. Improvement - continue for 3 more weeks, then start reducing regime.
3. No improvement - stop steroids as probably not polymyalgia rheumatica