Polymyalgia Rheumatica

Rheumatology

Inflammatory condition over 50 causing bilateral shoulder and pelvic girdle pain and stiffness with raised inflammatory markers.

Clinical features

  • Bilateral shoulder/hip girdle ache
  • Morning stiffness >45 min
  • Difficulty rising from a chair or combing hair

Investigations

  • ESR/CRP raised
  • CK normal (distinguishes from myositis)
  • TFT, myeloma screen, ANA, RF to exclude mimics

Management

  • Prednisolone 15 mg OD — dramatic response within 1 week is expected
  • Taper slowly over 12–24 months
  • Bone protection and PPI

Clinical pearls

  • Absent steroid response within a week should prompt review of the diagnosis
  • Screen for GCA symptoms at every visit

Related in WardRound

Educational — verify locally.

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