Polymyalgia rheumatica
An inflammatory condition usually occurring after age 50, with pain and stiffness in the shoulder and pelvic girdles.
About the condition
An inflammatory condition usually occurring after age 50, with pain and stiffness in the shoulder and pelvic girdles.
Inflammation around joints causes pain and stiffness rather than primary muscle destruction. Its association with giant cell arteritis matters.
Symptoms
After age 50, shoulder and hip girdle pain and prolonged morning stiffness develop. Fatigue and weight loss may occur.
Dressing, lifting arms and rising after rest may be difficult. True muscle weakness or atypical age prompts alternative diagnoses.
Diagnosis
Assess symptoms, ESR/CRP and alternative diagnoses. Treatment response alone does not prove the diagnosis.
Exclude elderly-onset RA, myopathy, infection and other causes. Shoulder and hip ultrasound may support an inflammatory explanation.
Treatment
Glucocorticoids are usually prescribed and tapered under supervision. Osteoporosis risk and other adverse effects are addressed.
Tapering needs regular review, especially when symptoms recur. Relapse or toxicity may prompt steroid-sparing treatment.
Monitoring
Monitor recurrent stiffness and adverse effects. New headache, jaw pain when chewing or visual changes need urgent assessment.
Monitor blood pressure, glucose, bone risk and infections. Interpret ESR/CRP alongside symptoms rather than in isolation.
Sources
Content date: