POLYMYALGIA RHEUMATICA-HISTORY

SUMMARY

1. Polymyalgia rheumatica (PMR) is a clinical syndrome that is classically associated with giant cell arteritis and may be a milder manifestation of the same disease.

2. 20% of PMR patients develop GCA. Conversely, in those with GCA, 50% also have symptoms of PMR or have already been diagnosed with PMR.

3. Think of PMR in the older patient with a history of profound morning stiffness, bilateral shoulder girdle and hip aching, and hand swelling (mimicking RA).

4. Remember: PMR pain is out of proportion to exam findings.

5. PMR is distinguished from polymyositis by the absence of objective weakness.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].