Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is an inflammatory condition in adults over 50 years of age. Clinical presentations may include acute to subacute symmetric pain and stiffness in neck, shoulders, hip and/or thighs, morning stiffness lasting at least 30 minutes, often with constitutional symptoms including generalized weakness, fatigue, diminished appetite, weight loss, or even low-grade fevers. PMR is associated with giant cell arteritis (GCA). The most common symptoms in GCA include temporal headaches, vision changes, and jaw or tongue claudication while eating. The feared outcome of GCA is permanent vision loss. Most patients with PMR have elevated ESR and CRP, and are typically very responsive to glucocorticoids. If a patient with PMR develops symptoms of GCA, they should be immediately referred to the emergency room to receive high dose glucocorticoids.