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Polymyalgia Rheumatica (PMR) - Coggle Diagram
Polymyalgia Rheumatica (PMR)
Definition
Polymyalgia rheumatica (PMR) is an inflammatory rheumatological syndrome that manifests as pain and morning stiffness involving the neck, shoulder girdle, and/or pelvic girdle in individuals older than age 50 years
Signs/Symptoms
Shoulder/hip girdle
Pain
stiffness
Rapid response to corticosteroids
low grade fever
anorexia
weight loss
malaise
depression
asthenia (abnormal physical weakness or lack of energy)
Risk factors
Age > 50
Giant cell artheritis
female sex
Epidemiology
The incidence increases with age, typically occurring in those older than 50 years and rarely in younger individuals
age- and sex-adjusted annual incidence of PMR was 63.9/100,000 population aged ≥50 years
Aetiology
Exact cause is unknown
seasonal variance suggests a role by infectious agents such as adenovirus and RSV
Investigations
ESR
CRP
FBC
Management
corticosteroids
low dose
intramuscular methylprednisolone can be considered for patients who are poorly adherent to treatment
methotrexate should be considered early during the course of treatment on an individual basis
Complications
chronic relapsing PMR
corticosteroid use
increased risk of infection
osteoperosis
type 2 diabetes mellitus
hypertension
muscle weakness
glaucoma
skin changes
Catarct development
giant cell arthritis
Methotrexate
myelosuppression
oral ulcers
hepatotoxicity
interstitial lung disease
Liver injury secondary to tocilizumab
Prognosis is good