Polymyalgia Rheumatica (PMR) Flashcards
Define Polymyalgia Rheumatica (PMR)
Chronic, systemic inflammatory disease
Characterised by myalgia (muscle aches and pain) and morning stiffness in the neck, shoulder, and pelvic girdle
What are the key characteristics of Polymyalgia Rheumatica (PMR)
Myalgia (muscle aches and pain) and morning stiffness in the neck, shoulder, and pelvic girdle
Name the condition in which is strongly associated with Polymyalgia Rheumatica (PMR)
Temporal arteritis
also known as giant cell arteritis
Name the 4 risk factors for Polymyalgia Rheumatica (PMR)
- Comorbidity of temporal arteritis
- Older age (> 50 years)
- Female gender
- Northern European ancestry
What causes Polymyalgia Rheumatica (PMR)
The exact cause is unknown
Theorised that the condition is triggered by an environmental cause in a genetically predisposed person
Polymyalgia Rheumatica (PMR) is characterised by myalgia (muscle aches and pain) and morning stiffness in which joints
Bilateral shoulder and/or hip girdle
Polymyalgia Rheumatica (PMR) is characterised by myalgia (muscle aches and pain)
How long does these aches and pains usually last?
More than 2 weeks
Polymyalgia Rheumatica (PMR) is characterised by myalgia (muscle aches and pain) and stiffness.
What time of the day is the stiffness
Morning
Polymyalgia Rheumatica (PMR) is characterised by myalgia (muscle aches and pain) and morning stiffness in bilateral shoulder and/or hip girdle.
Is this ache and pain worse or better on movement
Worse with movement
Working diagnosis of polymyalgia rheumatica (PMR) should be made from a combination of what four criteria
Presence of clinical features
Exclusion of differential diagnosis
Positive response to oral corticosteroids within a week
Normalisation of inflammatory markers within 4 weeks (ESR + CPR)
What is the key treatment in polymyalgia rheumatica (PMR)
Corticosteroids
- Symptoms respond to treatment with corticosteroids within 72 hours
- Failure for quick respond prompt consideration of an alternative diagnosis
Why must blood glucose be monitored when taking long term steroids
Risk of steroid induced diabetes or worsening glycaemic control in known diabetics
Name 3 complications of long term steroid use
Osteoporsis
Gastric ulcers
Steroid induced diabetes
Osteoporosis is a potential complication of long term steroid use.
How do we protect patients
Bisphosphonate
Vitamin D and C supplementation
Gastric ulcers are a potential complication of long term steroid use.
How do we protect patients
PPI
