General practice & primary care · UKMLA & AKT
Polymyalgia rheumatica
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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