Polymyalgia Rheumatica - Week 17

Question 1

What is polymyalgia Rheumatica?

Answer 1

Inflammatory condition, non-specific pain and stiffness of muscles

Associated with Giant cell arteritis

Question 2

Who can get PMR?

Answer 2

Always over 50
Mainly women

Question 3

What is the pathophysiology of PMR?

Answer 3

Unclear
Immune imbalance
Associated with HLA DR4

Question 4

Presentation of PMR?

Answer 4

Symmetrical pain weakness and stiffness (shoulders, hips, back)
Poor sleep
> 45 mins morning stiffness
Systemic symptoms
Movement problems due to pain

Question 5

What acronym can help with clinical features of PMR?

Answer 5

SECRET

Stiffness/pain
Elderly pts
Constitutional symptoms
Rheumatism
ESR elevated
Temporal arteritis

Question 6

What investigations can be done for polymyalgia rheumatica?

Answer 6

High ESR
CRP elevated
Anti CCP to rule out RA
ANA to rule out SLE

USS and biopsy for GCA

Question 7

Management for PMR?

Answer 7

Glucocorticoids (prednisolone)
Bisphosphonates and Vit D
Physio
Methotrexate or Azathioprine for flares

Question 8

Prognosis for PMR?

Answer 8

Good prognosis
Relapses common