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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