MSK: Polymyalgia Rheumatica: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Polymyalgia Rheumatica (PMR)🎧 A focused, high-yield guide to PMR – the classic inflammatory condition causing shoulder and hip stiffness in older adults. Perfect for MSRA prep and real-life practice 🩺🧠 Key Learning Points📌 Definition• PMR = Inflammatory disorder causing muscle pain & stiffness, mainly in shoulders and hips• Commonly linked to Giant Cell Arteritis (GCA)📌 Causes & Risk Factors• Age >50 (peak in 70s)• Female sex• Northern European ancestry• Likely autoimmune – trigger unknown🧠 Mnemonic: “OLD-FEM” – Over 50, Lady, Descendant of Europe, Fatigue, Elevated markers, Morning stiffness📌 Pathophysiology• Inflammation in synovial tissues & periarticular structures• Cytokine activity (esp. IL-6) → pain & stiffness• No true muscle damage (CK usually normal)📌 Symptoms• Bilateral shoulder & hip girdle pain• Morning stiffness >45 mins• Fatigue, malaise, low-grade fever• Rapid onset over weeks🧠 Think: "STIFF not WEAK" – stiffness dominates, not true weakness📌 Differential Diagnosis• RA, SLE, Psoriatic arthritis• Myopathies (e.g. polymyositis)• Osteoarthritis, statin-induced myalgia• Malignancy, infection (e.g. endocarditis, TB)• Thyroid disorders, fibromyalgia, GCA📌 Diagnosis• Clinical diagnosis + exclusion of other causes• Raised CRP & ESR• CK normal (no muscle damage)• RF/anti-CCP negative• Imaging (US/MRI): bursitis or tenosynovitis may support🧠 Clue: Rapid steroid response = diagnostic aid📌 Management• Prednisolone 15mg daily – rapid symptom relief• Taper slowly once stable• Monitor symptoms, ESR/CRP regularly• Add bisphosphonates if high fracture risk• Consider methotrexate for frequent relapses🧠 Always rule out GCA: jaw claudication, scalp tenderness, vision loss → needs urgent high-dose steroids📌 Complications• Relapse (common – needs dose adjustment)• GCA (15% risk)• Steroid side effects: osteoporosis, DM, HTN, infection📌 Prognosis• Excellent in most – symptoms resolve with steroids• Duration: often 1–2 years, sometimes longer• No impact on life expectancy, but steroid risks must be managed📎 More MSRA Resources for Polymyalgia Rheumatica📝 Revision Notes:https://www.passthemsra.com/topic/polymyalgia-rheumatica-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/polymyalgia-rheumatica-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/polymyalgia-rheumatica-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/polymyalgia-rheumatica-rapid-quiz/🎯 Quiz Page:https://www.passthemsra.com/quizzes/polymyalgia-rheumatica/🎓 Full MSK Course:https://www.passthemsra.com/courses/msk-for-the-msra/#MSRA #MSRARevision #PolymyalgiaRheumatica #PMRMSRA #MSRAFlashcards #MSRAQuiz #MSRAQANotes #MSRAAccordions #MSKforMSRA #MSRAClinicalRevision #PassTheMSRA