Polymyalgia Rheumatica

Polymyalgia rheumatica (PMR) is roughly 10 – 20 times more common than the inflammatory myopathies ( ~ 1/1,000 vs 1/20,000). Just like the inflammatory myopathies, most patients are adult women with limb-girdle weakness. PMR patients are generally slightly older (70 y.o.) than inflammatory myopathies (50 y.o.) and in PMR. PMR has a higher incidence in whites than in blacks. Patients develop pain and stiffness rather than frank motor weakness (the weakness is a functional condition), because this is an inflammatory arthropathy NOT a myopathic process. The CPK should be normal (or relatively normal) and the ESR (erythrocyte sedimentation rate) is elevated (at least > 40) in 85% of cases. Note that other inflammatory markers, including CRP (C reactive protein) are also elevated. Glucocorticoids (anti-inflammatories) can quickly reduce the arthropathy and unlock the functional weakness.