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This diagnosis is possible but very rare if normal inflammatory markers
Polymyalgia rheumatic (PMR) is a chronic inflammatory disease of unknown aetiology which presents with pain and stiffness that is worst in the morning and particularly affects the shoulders and hips
Diagnosis of PMR should be made by building up a weight of evidence by
Core inclusion criteria are
Core exclusion criteria are evidence of a differential diagnosis as described below
NB: steroids are potent anti-inflammatory agents and can mask symptoms from a range of diseases
GCA symptoms especially visual symptoms or jaw claudication
Treatment regime – guide only – should be tailored to the patient, but treatment is for 1-2 years.
Follow up at 2 weeks
Evidence in favour of PMR if
Refer if diagnostic uncertainty or difficult management.
GPs and patients can refer to Improving Lives Plymouth for patient support with any long-term physical or low level mental health condition. The service helps people to better manage their condition and to achieve a better quality of life.
This guideline has been signed off by the Western Locality on behalf of NEW Devon CCG.
Publication date: February 2017
Updated: October 2018