MusculoskeletalPending review

Polymyalgia Rheumatica

An inflammatory disorder of the shoulder and hip girdle synovium and periarticular structures in older adults, producing bilateral proximal pain and stiffness that resolves dramatically with corticosteroids, and closely linked to giant cell arteritis.

In a nutshell

Cytokine-driven inflammation of periarticular structures around the shoulder and hip girdles causes bilateral proximal pain and prolonged morning stiffness in older adults. It shares its mechanism and age group with giant cell arteritis, so every patient must be screened for cranial symptoms, and the diagnosis is supported by a dramatic response to low-dose steroids.

Classic presentation

A patient over 50 with several weeks of bilateral shoulder and hip girdle pain and stiffness, worse in the morning, difficulty rising from a chair or dressing, and a raised ESR/CRP.

Key points

The mechanism is periarticular and synovial inflammation around the girdles, not small joint synovitis: this produces proximal pain rather than swollen individual joints.

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Educational content pending clinical review. Not medical advice.