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: ÂESR,
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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