PMR

Question 1

Describe the typical sufferer of PMR.

Answer 1

• F>M, >50yo, Caucasian

Question 2

Write brief notes on the pathological manifestations of PMR.

Answer 2

• The pathological changes are poorly understood.
• No specific histological changes in the muscles.
• There are no inflammatory infiltrates as is the case of polymyositis/dermatomyositis.

Question 3

List and discuss the major symptoms of PMR.

Answer 3

1. Muscle pain/aching: 
•	Areas most often affected: 
o	neck 
o	pectoral girdle 
o      pelvic girdle
o	upper back 
•	Do not observe muscle weakness or EMG abnormalities.

2. Morning stiffness:
   • Occurs in the same areas as the muscle pain, but is usually worse in:
   o shoulder girdles
   o hip girdles
   • Always have “gelling” ie. stiffness after inactivity.

3. Systemic complaints: 
•	malaise 
•	depression/apathy
•	lethargy 
•	tiredness
•	LG Fever
•	LoW

Question 4

List and discuss the major signs of PMR.

Answer 4

• PMR has marked symptoms, but few physical findings:

• May observe:
o absence of muscle weakness
o slow and difficult movements
o +/- small synovial effusions

Question 5

PMR may be an early manifestation of Cranial arteritis. Which clinical manifestations may indicate the development of temporal arteritis?

Answer 5

Temporal arteritis may result in blindness thus the patient must be warned that they must seek help if the following symptoms and signs appear:
• HA
• visual disturbance
• jaw claudication

Question 6

Which complication of temporal arteritis should the patient be warned of?

Answer 6

Blindness -> d/t occlusion of opthalmic Aa.