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Chapter: Medicine Study Notes : Musculo-Skeletal

Polymyalgia Rheumatica - Connective Tissue Diseases

Old ladies with morning stiffness in proximal muscles +/- mild polyarthritis, depression, fever, anorexia, maybe jaw claudication, angina, hypopituitarism, not weakness

Polymyalgia Rheumatica

 

·        Old ladies with morning stiffness in proximal muscles +/- mild polyarthritis, depression, fever, anorexia, maybe jaw claudication, angina, hypopituitarism, not weakness

 

·        May be features related to underlying CTDs (arthritis if superimposed RA, headache in GCA Þ ask about headaches, visual disturbance etc)

 

·        ?Syndrome with many underlying causes (eg variety of connective tissue diseases)


·        Differential:

o   RA with onset of central joints

o   Frozen shoulder

o   Carcinomas: breast, thyroid, prostate

o   Myeloma

o   Polymyositis

o   Bacterial endocarditis

 

·        Investigations: ­ESR, anaemia, no abnormality on X-ray, usually RF and ANA negative, CK not usually raised, liver involvement ® ­ ALP

 

·        Treatment: dramatic response to low dose steroids (eg 15 mg/day)

 

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Medicine Study Notes : Musculo-Skeletal : Polymyalgia Rheumatica - Connective Tissue Diseases |


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