Polymyalgia Rheumatica (PMR)

Question 1

What is it?

Where does it affect? - 3

Answer 1

A condition that causes pain, stiffness and inflammation in the muscles around the shoulders, neck and hips.

Question 2

What other disease is it linked to?

Answer 2

Giant Cell Arthritis (GCA)

Can present at the same time

Question 3

S+S:

What symptoms do they have?

What systemic symptoms may they have?

Answer 3

Pain - presents as an ache
Tenderness
Morning stiffness

Weight loss 
Fever 
Fatigue 
Anorexia 
Depression

Question 4

Investigations:

What enzyme found in the liver and the bones may be raised?

What is measured in the blood to test for myopathies/myositis and can, therefore, be used to rule them out in this case?

Answer 4

Alkaline Phosphatase (ALP)

Creatine Kinase

Question 5

Management:

Steroids are given for this. The response to Rx is used to know whether it is PMR. Does the response to Rx happen very quickly or very slowly?

Methotrexate can be added if Rx inadequate!

Answer 5

Very quickly - usually within 2 days