Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about polymyalgia rheumatica. And you can follow along with written notes on this topic

at zero definals.com slash pmr or in the rheumatology section of the zero to finals medicine book.

So let's get straight into it.

Polymeridurumatica is an inflammatory condition that causes pain and stiffness in the shoulders,

the pelvic girdle and the neck.

There are strong associations with giant cell arthritis or temporal arthritis and the two conditions often occur together.

Both conditions respond very well to treatment with steroids. There's very good nice clinical knowledge

summaries on polymer gerumatica and I suggest you read them before treating patients. However, there's a summary here just to help with your learning and your revision.

So with PMR, it's very important to talk about the demographics of the patients that are affected.

It usually affects older adults above the age of 50 years.

It's more common in women and also more common in Caucasians. So in your exams, the typical

patient will be around 60 years old, female and white. So what are the core features? Well,

the clinical knowledge summaries from Nice give us some core features that can be used to determine

which patients have polymage rheumatica and these features should

be present for at least two weeks before we make the diagnosis. Firstly there'll be bilateral shoulder pain

that may radiate to the upper arms and down to the elbow bilateral pelvic girdle pain so this is

pain throughout the whole pelvic girdle and hips.

The pain is worse with movement. It interferes with sleep.

And there's profound stiffness in these joints, which typically lasts at least 45 minutes in the morning

before they're able to get the joints moving and loosened up.

Some other features are systemic symptoms like weight loss, fatigue, low grade fever and low mood.

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