General practice & prim · UKMLA & AKT
Polymyalgia rheumatica
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise polymyalgia rheumatica — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Bilateral proximal pain - shoulders and/or pelvic girdle (hips); may begin unilaterally but quickly becomes bilateral
- Morning stiffness - lasting at least 45 minutes; patients struggle to get out of bed, lift arms above head, or rise from a chair
- No true muscle weakness - power preserved (5/5) on formal testing; apparent weakness is pain-limited, not myopathy
- Constitutional symptoms - fatigue, low-grade fever, anorexia, weight loss, depression
- Age >50, female predominance (2:1), rare under 50
Pain in PMR arises from inflamed periarticular tissue (synovitis/bursitis), NOT the muscle itself - this is why passive shoulder movement is less painful than active, and why true weakness is absent.
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