POLYMYALGIA RHEUMATICA (PMR)
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Clinical syndrome characterized by aching and morning stiffness in the shoulder girdle, hip girdle, or neck for >1 month, elevated ESR, and rapid response to low-dose prednisone (10–20 mg qd). Rarely occurs before age 50; more common in women. PMR can occur in association with giant cell arteritis, which requires treatment with higher doses of prednisone. Evaluation should include a careful history to elicit symptoms suggestive of giant cell arteritis (Chap. 159); ESR; laboratory test results to rule out other processes usually include RF, ANA, CBC, CPK, serum protein electrophoresis; and renal, hepatic, and thyroid function tests.