Rheumatology 8 - Polymyalgia Rheumatica Flashcards
1
Q
5 signs of polymyalgia rheumatica (+ bonus features)
A
bilateral shoulder pain pelvic girdle pain worse on movement can't sleep stiff for 45+ mins in morning
(+ FLAWS, carpal tunnel, pitting oedema)
2
Q
DDx of polymyalgia rheumatica
A
diagnosis of exclusion, more likely to be something else
consider other rheum osteoarthritis cervical spondylosis adhesive capsulitis thyroid issue fibromyalgia
3
Q
diagnosing PMR
A
clinical presentation + steroid responsiveness
would expect symptom improv + lowering of ESR after 1 week preds
4
Q
treating PMR
A
15mg pred daily
should see 70% improv after 3 weeks
followed by reducing regime + off steroids long term (can take up to 2 years)
5
Q
investigating PMR (account for DDx)
A
FBC, UE, LFT calcium serum protein electrophoresis TSH CK RF urine dip CXR
other autoabs
6
Q
long term steroids advice
A
don’t stop!
steroid dependent after 3 weeks so will have adrenal crisis if they stop cold turkey
sick day rules (increase dose)
treatment card
osteoporosis prophylaxis (supplements + bisphos)
PPI - gastric protection
