Polymyalgia Rheumatica Diagnosis and Management

Diagnostic Considerations

• The EULAR/ACR guidelines recognize that PMR with normal inflammatory markers is an atypical presentation that warrants specialist referral 1, 2
• High baseline ESR (>40 mm/1st hour) is associated with higher relapse rates and need for prolonged therapy, according to the EULAR/ACR guidelines 1, 2

Monitoring and Management

• Even in patients who initially present with normal inflammatory markers, ESR and CRP should still be monitored during follow-up as they may become elevated during disease flares, as recommended by the EULAR/ACR guidelines 1
• The treatment approach remains the same regardless of baseline inflammatory marker status - glucocorticoids are the cornerstone of therapy, as stated by the EULAR/ACR guidelines 1, 2