Polymyalgia rheumatica

Polymyalgia rheumatica is an inflammatory rheumatic disease characterized by: 
  • Bilateral shoulder and/or pelvic girdle aching 
  • Morning stiffness >45 minutes duration 
  • Raised ESR
  • Systemic symptoms
    • Low grade fever 
    • Weight loss 

Average age of onset is >70. It is very rare in those <50.
Females > males (3:1) 
People of north European ancestery more likely to be affected.
There is evidence of a link to HLA DR4 

  • Oral prednisolone – 15mg OD – tends to improve condition dramatically within days. Taper dose to lowest level that works. 
  • Limit risks of adverse effects of steroid treatment, e.g. with osteoporosis prophylaxis. 
  • IM methylprednisolone may be used in milder cases and may reduce the risk of steroid-related complications. 

Complications associated with PMR:

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