polymyalgia rheumatica

Case presentation Prepared by Dr R Musa

GP referral ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Social history ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

On examination ,[object Object],[object Object],[object Object],[object Object],[object Object]

D/D ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Investigation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],reducing dose of steroid should be based on sign & symptoms rather than CRP & ESR value, which dose not predicate relapse Therapy usually last two years, relapse usually in the 1st or 2nd month

PMR (diagnostic criteria) ,[object Object],[object Object],[object Object],[object Object]

Pathogenesis of PMR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classic RA ,[object Object],[object Object],[object Object],[object Object],[object Object]

Sero (-) LO-RA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Polymyalgia rheumatica vs late-onset rheumatoid arthritis M. Cutolo1, M. A. Cimmino1 and A. Sulli1 ( Rheumatology 2009 48(2):93-95) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Polymyalgia rheumatica vs late-onset rheumatoid arthritis M. Cutolo1, M. A. Cimmino1 and A. Sulli1 ( Rheumatology 2009 48(2):93-95) Slow response Dramatic response Response to 15 mg steroid HLA-DRB1 allele HLA-DRB1 allele HLA allele Mildly elevated higher ESR, CRP & IL6. ESR & CRP Main sign Less frequent More myalgia Arthritis of PIP, MCP and wrist joints Older Relatively younger Age > 80% 23% Synovitis Sero–ve LO-RA PMR

polymyalgia rheumatica

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polymyalgia rheumatica