My Dream

Setting higher standards

Diagnosis and
management of
polymyalgia rheumatica

Concise guidance to good practice series

June 2010

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■ CONCISE GUIDANCE

Clinical Medicine 2010, Vol 10, No 3: 270–74

Concise guidance: diagnosis and management of polymyalgia
rheumatica
Bhaskar Dasgupta on behalf of the Polymyalgia Rheumatica Guideline Development Group*

ABSTRACT – Polymyalgia rheumatica (PMR) is among the
most common reasons for long-term steroid prescription
with great heterogeneity in presentation, response to
steroids and disease course. The British Society for
Rheumatology and the British Health Professionals in
Rheumatology have recently published guidelines on management of PMR. The purpose of this concise guidance is
to draw attention to the full guidelines and provide a safe
and specific diagnostic process with advice on management
and monitoring – specifically targeted at general practitioners, general physicians and rheumatologists.
KEY WORDS: diagnosis, polymyalgia rheumatica, steroid
therapy, treatment

Introduction and aims
Polymyalgia rheumatica (PMR) is one of the most common
inflammatory rheumatic diseases of the elderly and represents
one of the frequent indications for long-term corticosteroid
therapy in the community. Its management is currently subject
to wide variations of clinical practice and it may be managed in
primary or secondary care by general practitioners (GPs),
rheumatologists and non-rheumatologists.
The diagnosis of PMR can be challenging, as many clinical
and laboratory features may also be present in other conditions,
including other rheumatological diseases, infection and neoplasm. Also, the response to standardised therapy is heterogeneous, and a significant proportion of patients do not respond
completely.

Aims of the guideline
The objective of this concise guidance is to produce a summary
of the longer British Society...