In this episode, we review polymyalgia rheumatica (PMR), an inflammatory rheumatic condition that commonly affects adults over age 50 and presents with symmetrical pain and stiffness of the shoulders, neck, and hip girdle. We discuss the immune-mediated pathophysiology, including the role of IL-6–driven inflammation, and the strong association with giant cell arteritis (GCA). The episode highlights classic clinical features such as morning stiffness lasting more than 45 minutes, rapid onset of symptoms, and difficulty with everyday activities like rising from a chair or lifting the arms. We also review key diagnostic clues including elevated ESR and CRP with negative autoimmune serologies, supportive imaging findings, and the ACR/EULAR classification criteria. Finally, we cover treatment strategies—particularly glucocorticoids as first-line therapy, steroid tapering protocols, and monitoring for complications—along with high-yield clinical pearls for recognizing PMR in clinical practice and on board exams.

References

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