Polymyalgia Rheumatica

Diagnose by 5 positive criteria or suspectected polymyalgia rheumatica when 4 positive criteria exists.

1. At least 4 weeks of proximal myalgi in shoulder or hips

2. Morning stiffnes in joints > 30 minutes

3. No arthritis, minimal synovitis in fingers and discrete swelling in other joints

4. SR > 40

5. Age > 50 years

6. No other known cause for sedimentation rate

Treatment

Begin with 30 mg Prednisolone ( 15 mg with mild symtoms)

From the starting dose

 Decrease the dose with 5 mg / week untill reaching 20 mg.

 Decrease thereafter with 2,5 mg each month down to 5 mg

Decrease thereafter with 1 mg /month

The sedimentation rate should decline significantly and the myalgi improve considerably after 2 weeks of treatment. If this isn´t the case then re-evaluate the diagnosis.