Symptoms of Polymyalgia Rheumatica

Featuring Dr. John Watterson, MD, FRCPC Video Tile" Symptoms of Polymyalgia Rheumaticak
Duration: 2 minutes, 3 secondsSymptoms of Polymyalgia Rheumatica

Polymyalgia rheumatica is a systemic inflammatory condition.  

It's a relative of rheumatoid arthritis. So the most typical manifestations that will bring one to their physician to examine them and try and figure out what's wrong is the sudden onset of stiffness and difficulties arising in the morning.  

This will alert the healthcare professional that there is something going on, that this was a person that previously was well and had no difficulties getting out of bed in the morning, raising their arms above their head, getting off a chair or up a flight of stairs.  

Some features that aren't generally present in polymyalgia rheumatica are involvement of the smaller joints; for instance, the wrist, the smaller joints in the hands, the knees, the ankles, and the feet. It's proximal limb girdle symptoms.  

The other feature that your family doctor or healthcare professional will be asking about is whether there is an improvement through the day or improvement with over-the-counter medications, such as ibuprofen or aspirin. Those are sort of fairly telltale signs that it may be an inflammatory condition.  

Blood tests are part of the key to diagnosing this disorder, whereby almost inevitably, there are certain markers in the blood called acute phase reactants that are elevated. Those include sedimentation rate or C-reactive protein, and these are characteristically very, very high in this condition.  

The other feature that we use as almost a litmus test to see whether or not we're dealing with polymyalgia rheumatica or some other form of musculoskeletal disease is a course of prednisone. Prednisone is a powerful anti-inflammatory drug.

It's considered a steroid. Used at doses between 10 and 20 milligrams daily for this condition alleviates symptoms almost within a day or two.  

And that's a very telltale feature of polymyalgia rheumatica, the dramatic response within a day or two to steroids at a relatively low dose. There's not very many other conditions that will respond like that. 

Presenter: Dr. John Watterson, Rheumatologist, Victoria, BC

Local Practitioners: Rheumatologist