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Polymyalgia Rheumatica


Noleen Smith, 4th-year Medical Studentt, Guy's King's and St Thomas' Medical School, London, UK.
Mark Harding, MD, MBBCH(Wits), FRACGP, Dip Occ Health, BSc (QS) Hons, General Practitioner, Inverell, New South Wales, Australia.

Polymyalgia rheumatica (PMR) has a female predominance and typically occurs in people over 50 years of age. PMR usually presents as pain and stiffness in the neck, shoulder, and pelvic areas. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels are used to determine disease activity. PMR is thought to be a systemic component of giant cell arteritis with aborted vasculitis. Other studies have looked at infectious agents as a causative factor. PMR is treated using a corticosteroid regime that, in turn, causes many unwanted side effects. Various methods to decrease these unwanted effects have been studied, including the addition of methotrexate as a steroid-sparing agent and intramuscular injection of methylprednisolone rather than oral prednisolone.
Key words: erythrocyte sedimentation rate, C-reactive protein, vasculitis, corticosteroids, side effects.