Polymyalgia rheumatica (musculoskeletal manifestations)

Musculoskeletal manifestations of polymyalgia rheumatica are the commonest presentation of polymyalgia rheumatica.

Epidemiology

Polymyalgia rheumatica is the most common inflammatory rheumatic condition in older adults .

Clinical presentation

Patients typically present with :

  • shoulder or pelvic girdle aches lasting over 2 weeks
  • morning shoulder or pelvic girdle stiffness
  • raised inflammatory markers (e.g. ESR)

Pathology

Associations

Radiographic features

Ultrasound

Although usually not required ultrasound may commonly show :

  • bilateral subacromial bursitis
  • biceps long head tenosynovitis
  • trochanteric bursitis

Treatment and prognosis

Treatment is usually low dose corticosteroids which most patients respond well to .

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