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Polymyalgia rheumatica - Management
What are the signs of polymyalgia rheumatica?
- Bilateral upper arm tenderness is sometimes present. Shoulder abduction is often uncomfortable and may be limited by pain.
- Muscle strength is not usually impaired, but muscle pain may make testing difficult. If symptoms are protracted, disuse atrophy of muscle can occur, leading to muscle weakness.
- Peripheral musculoskeletal signs are seen in approximately 50% of people. They include:
- Carpal tunnel syndrome.
- Peripheral arthritis (predominantly affecting the knees and wrists), which is asymmetric, non-erosive, and self-limiting.
- Swelling with pitting oedema of hands, wrists, feet, and ankles.
- Scalp tenderness and visibly thickened and tender temporal arteries are signs indicative of giant cell arteritis, and may be present in 10–20% of people with polymyalgia rheumatica.
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