Polymyalgia Rheumatica: The Daily PANCE Blueprint

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Polymyalgia Rheumatica: The Daily PANCE Blueprint

A 62-year-old female with a history of hypertension presents to your clinic with back, shoulder, and hip stiffness in the morning. On physical exam, you note 2+ reflexes in all extremities and no associated weakness. Labs reveal severely elevated ESR and CRP. Which of the following is the treatment of choice for this patient?

A. Methotrexate
B. Systemic steroids
C. Alendronate
D. Vitamin D and calcium
E. Sulfasalazine (Azulfidine)

Answer and topic summary

The answer is B. Systemic steroids

Polymyalgia rheumatica (PMR) is a type of inflammatory rheumatologic condition. It classically presents as stiffness in the bilateral shoulders and hip girdle. Other symptoms include fatigue, weight loss, and low-grade fever. It typically impacts people over the age of 50. ESR and CRP are usually elevated. There is no test or definitive criteria for diagnosing PMR. Treatment is systemic steroids (prednisone 15 mg/day). Also, it’s important to know that people with this disease are 2-3 times more likely to get temporal arteritis.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Rheumatologic Disorders ⇒ Polymyalgia rheumatica

Also covered as part of the Internal Medicine PAEA rotation content blueprint topic lists