Polymyalgia Rheumatica (PMR)

Exam Cram

• Polymyalgia rheumatica is a

• Presentation: bilateral shoulder and hip pain and stiffness with raised inflammatory markers

• Diagnosis: ?clinical

• Management: low dose steroids, e.g. 12.5mg prednisolone OD

Outline

Background 

• Heavily linked with Giant Cell Arteritis

Assessment

History:

• Progressive shoulder and hip inflammatory pain

• Worse for > 30 mins in morning, better with exercise

• Over 50yrs

Examination:

• Pain and stiffness in hips & shoulders

Investigations

• Raised CRP/ ESR

Diagnosis

Diagnostic criteria: 

Differentials: Giant Cell Arteritis, Paget's Disease, Osteoarthritis 

Management

Acute

1. Low dose pred, e.g. 12.5-25mg  daily, three weeks

Long term

1. Weaning dose pred

2. Steroid sparing agents

References and Resources

Page written in 2024.