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
Treatment
- 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:
References
