Polymyalgia rheumatica (PMR) is an inflammatory disorder that causes muscle pain and stiffness, particularly in the shoulders, hips, and neck. It typically affects adults over the age of 50 and is more common in women than men.
Symptoms: Include severe stiffness, especially in the morning or after prolonged inactivity, and can be accompanied by a low-grade fever and fatigue.
Diagnosis: Based on clinical presentation, elevated inflammatory markers (ESR and CRP), and response to corticosteroids.
Treatment: Usually involves low-dose (15mg) corticosteroids, which can rapidly alleviate symptoms. Long-term steroids (over 1 year) may be necessary to prevent relapses. Monitoring for potential complications, such as osteoporosis, is important.
Association with Giant Cell Arteritis: PMR can coexist with giant cell arteritis (GCA), a serious condition that requires immediate treatment to prevent complications like vision loss. Crossover is about 15% and treatment is high dose steroids.