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. 2010 Jun;10(3):270-4.
doi: 10.7861/clinmedicine.10-3-270.

Concise guidance: diagnosis and management of polymyalgia rheumatica

Dasgupta Bhaskar  1
Affiliations

Concise guidance: diagnosis and management of polymyalgia rheumatica

Dasgupta Bhaskar. Clin Med (Lond). 2010 Jun.

Abstract

Polymyalgia rheumatica (PMR) is among the most common reasons for long-term steroid prescription with great heterogeneity in presentation, response to steroids and disease course. The British Society for Rheumatology and the British Health Professionals in Rheumatology have recently published guidelines on management of PMR. The purpose of this concise guidance is to draw attention to the full guidelines and provide a safe and specific diagnostic process with advice on management and monitoring--specifically targeted at general practitioners, general physicians and rheumatologists.

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Figures

Fig 1.
Fig 1.
A referral pathway for polymyalgia rheumatica (PMR) compatible with these guidelines is suggested in the Map of Medicine. CRP = C-reactive protein; CTD = connective tissue disease; ESR = erythrocyte sedimentation rate; FBC = full blood count; GCA = giant cell arteritis; IM = intramuscular; RA = rheumatoid arthritis; SLE = systemic lupus erythematosus; U&E = urea and electrolytes.
Fig 2.
Fig 2.
Recommendation on approach for the evaluation of proximal pain and stiffness. PTH = parathyroid hormone; RA= rheumatoid arthritis; RS3PE = remitting, seronegative symmetrical synovitis with pitting edema; SLE = systemic lupus erythematosus; TSH = thyroid stimulating hormone.
See this image and copyright information in PMC

Comment in

  • Polymyalgia rheumatica.
    Morris G. Morris G. Clin Med (Lond). 2010 Dec;10(6):641; author reply 641. doi: 10.7861/clinmedicine.10-6-641. Clin Med (Lond). 2010. PMID: 21413499 Free PMC article. No abstract available.

References

    1. Dasgupta B, Borg FA, Hassan N, et al. BSR and BHPR guidelines for the management of polymyalgia rheumatica. Rheumatology. 2010;49:186–90. doi: 10.1093/rheumatology/kep303a. doi: 10.1093/rheumatology/kep303a. - DOI - DOI - PubMed
    1. Dasgupta B, Kalke S. Polymyalgia rheumatica. In: Isenberg D, Maddison P, Woo P, Glass D, Breedveld F, editors. Oxford textbook of rheumatology, 3rd edn. Oxford: Oxford University Press; 2004. pp. 977–82. - DOI - DOI
    1. Dasgupta B, Hutchings A, Matteson EL. Polymyalgia rheumatica: the mess we are in and what we need to do about it. Arthritis Rheum. 2006;55:518–20. doi: 10.1002/art.22106. doi: 10.1002/art.22106. - DOI - DOI - PubMed
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    1. Dasgupta B, Dolan AL, Fernandes L, Panayi G. An initially double-blind controlled 96 week trial of depot methylprednisolone against oral prednisolone in the treatment of polymyalgia rheumatica. Brit J Rheumatol. 1998;37:189–95. doi: 10.1093/rheumatology/37.2.189. doi: 10.1093/rheumatology/37.2.189. - DOI - DOI - PubMed

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