Menopause

May 2011

Clinical

Polymyalgia rheumatica

Diagnosis and management

Volume 40, No.5, May 2011 Pages 303-306

Oliver van Hecke

Background

Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease and an indication for long term treatment with oral steroids. Its incidence rises progressively beyond the age of 50 years. For the most part, PMR is managed in primary care.

Objective/s

This article highlights the main points in the British Society for Rheumatology and the British Health Professionals in Rheumatology guidelines that may be useful to general practitioners in the primary care setting.

Discussion

Different levels of awareness of the condition between practitioners, and a lack of uniform diagnostic criteria may impede correct diagnosis and management of PMR. Updated international guidelines produced by the British Society for Rheumatology and the British Health Professionals in Rheumatology can aid diagnosis and direct treatment and disease monitoring.

Polymyalgia rheumatica (PMR) is a common rheumatic disease that affects patients middle aged and older. Its incidence increases progressively beyond the age of 50 years.1 The reported annual incidence in Europe and the United States of America varies between 1.3 and 11.3 per 10 000 individuals aged over 50 years.2–5 This wide variation may reflect differing levels of awareness of the condition between practitioners, or a lack of uniform criteria used to make the diagnosis. A United Kingdom study6 demonstrated that general practitioners do not always use established criteria to diagnose PMR. This may result in unnecessary further investigation and needlessly expose patients to the risks associated with long term steroid use.

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Correspondence afp@racgp.org.au

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