Polymyalgia rheumatica

- it means pain and stiffness in many muscles (neck shoulders hips especially)

- due to an inflammatory condition of the muscles

- onset can be both acute and insiduous

- WBC attacking joint lining

Typical history:

- usually in adults > 50 yo, women 2x > men

- acute/insiduous

- pain in their muscles on waking, so muhc so that activity is limited

- fatigue and LOA

- anemia

- general sense of being unwell

Look out for signs and symptoms of temporal arteritis: 50% have temporal arteritis

- fever headache

- jaw claudication

- tongue claudication

- reduced visual auity or acute visual loss

Investigations:

For polymyalgia rheumatica: no specific ones:

- FBC

- ESR and CRP are raised

For temporal arteritis:

- FBC: raised platelets

- ESR and CRP are raised

Gold standard for diagnosing temporal arteritis is biopsy of temporal artery from multiple parts

Imaging studise: US shows halo sign, others include MRI and CT

Treatment:

Pain relief and prevention of weakening of muscles:

- Exercise

- Mild pain: aspirin, ibuprofen

- Severe pain: steroids (prednisolone)