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From the American College of Rheumatology

Rheumatology for Primary Care
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Polymyalgia Rheumatica Case Study

Home ยป Polymyalgia Rheumatica Case Study
Polymyalgia Rheumatica Case Study
  • Case

  • Case

A 75 yo F with history of DM2, HTN, and OA presents with progressive stiffness originating in her shoulders and neck with more recent involvement of the bilateral lateral hips for 5 weeks.

History

  • Symptoms present in the morning and improve with activity.
  • Acetaminophen provides minimal relief.

Physical Exam

  • Normal VS
  • Pain with palpation of shoulders and lateral hips, preserved strength
  • No evidence of swelling in small joints of hands and feet
  • 5/5 strength in upper and lower extremities

Diagnostic Workup

  • Labs: CRP 31 mg/L (H), ESR 75 (H), CBC with mild normocytic anemia, CMP wnl
  • Imaging: shoulder x-ray with mild degenerative changes bilaterally
Diagnosis

Treatment

  • Prednisone 20 mg per day resolved patient’s symptoms within 48 hours, but blood sugar uncontrolled
  • Second line treatment: patient started on SQ sarilumab with ability to taper off of steroids and without recurrence of PMR symptoms

Diagnosis

Based on the diagnostic workup and clinical presentation, the patient has polymalgia rheumatica.

Related Links

Polymyalgia Rheumatica Overview

 

Giant Cell Arteritis Overview

 

ACR Polymalgia Rheumatica Guideline

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Primary Care2024-05-21T13:46:30+00:00

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This product was funded by a medical grant from Pfizer. The content was written by a physician work group. See Authors

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