Polymyalgia rheumatica

Management escalation pathway

• Diagnosis and treatment (corticoid therapy) can be done by oncologist/GP except when diagnosis is not clear or when there is lack of respons to corticoids (which suggests an alternative diagnosis)
• Corticoid treatment: 20 mg predni and tapering over 9-12 months (https://www.ncbi.nlm.nih.gov/pubmed/26352874)

Assessment and Investigations

• Blood sample: often elevated ESR/CRP (should be done before starting corticoids); CKs should be normal (in contrast to myositis)
• Check for symptoms of giant cell arteritis in order to avoid sudden blindness (discuss temporal artery biopsy with rheumatologist/internist)