Symptoms of Polymyalgia Rheumatica

Dr. John Watterson, MD, FRCPC, discusses diagnosis and symptoms of polymyalgia rheumatica.

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Dr. John Watterson, MD, FRCPC, discusses diagnosis and symptoms of polymyalgia rheumatica.
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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

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Quiz: Do You Understand Polymyalgia Rheumatica?

Questions
 
True
False
1

Polymyalgia rheumatica usually occurs slowly over time.

Explanation:

Polymyalgia rheumatica often occurs suddenly, causing pain and stiffness, generally in the shoulder and hip girdle, extending into the upper arms, thighs and the back of the legs.

2

Polymyalgia rheumatica can occur in tandem with temporal arteritis.

Explanation:

PMR can occur in tandem with temporal arteritis, a condition that causes inflammation of the arteries on the temples, causing pain or headaches.

3

Polymyalgia rheumatica treatments include prednisone to get the inflammation under control.

Explanation:

Polymyalgia rheumatica treatments include 10 to 20 milligrams of prednisone daily to get the inflammation under control, after which your dosage will be reduced.

4

Disease-modifying anti-rheumatic drugs are not a good treatment for polymyalgia rheumatica.

Explanation:

Other PMR medications include non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs) and analgesics like acetaminophen.

5

Polymyalgia rheumatica goes away in a few months or years in only 10 percent of people affected.

Explanation:

Polymyalgia rheumatica goes away in a few months or years in approximately half the people affected. In individuals who respond to treatment and are able to taper and discontinue treatment over time, there is a relapse rate approaching 30 to 40 percent over a lifetime.

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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