Oliver van Hecke
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.
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.
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
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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