Polymyalgia rheumatica is a syndrome characterized by symmetrical pain and stiffness in the shoulder and pelvic girdle muscles, most commonly affecting those over 50 years old. It is important to rule out giant cell arteritis when diagnosing PMR. Blood tests like ESR and CRP will often be elevated. Treatment involves corticosteroids, which provide rapid relief, and exercise. PMR has a generally good prognosis but relapses can occur if steroids are tapered too quickly.

1. POLYMYALGIA RHEUMATICA
Dr Hafiz Zayn Zafar

2. INTRODUCTION
It is a syndrome of symmetrical pain and
stiffness commonly affecting the
proximal muscles of shoulder and pelvic
girdle

3. EPIDEMIOLOGY
 The prevalence is approximately 0.5 to 0.7 %
 Incidence increases with age. Commonly affects people older than 50
years of age
 Twice as common in females
 Whites are more affected
 Commonly associated with Giant Cell Arteritis

6. IMPORTANT
ALWAYS RULE OUT GIANT CELL ARTERITIS
WHEN YOU SUSPECT OR DIAGNOSE
POLYMYALGIA RHEUMATICA

8. INVESTIGATIONS
No definite investigations, investigations are done to exclude other
conditions
 ESR and CRP will be raised (Normal in Rare Cases)
 Thyroid Profile
 RA factor
 Autoimmune profile (ANF, ANA, ANCA)
 Temporal Artery Biopsy if GCA suspected

9. MIMICKING CONDITIONS
 Fibromyalgia
 Hypothyroidism
 Rheumatoid Arthritis
 Systemic Vasculitis
 Inflammatory Myopathy
 Malignancy

10. TREATMENT
 Corticosteroids (5-20mg/day, Rapid Response)
 NSAIDs may be used as adjunct
 Sleep Hygiene
 Breathing Exercises
 ROM and Stretching Exercises
 Good nutrition and hydration

11. PROGNOSIS
 Good prognosis
 Not a life threatening condition
 Exacerbation is common if steroids tapered rapidly
 Relapses may occur

13. THANKS