PMR is a common inflammatory rheumatic condition in the elderly and is one of the biggest indications for long-term steroid therapy. There are difficulties in diagnosis, with heterogeneity in presentation, response to steroids and disease course.

BSR has published the following guidance in the management of PMR. 

Core inclusion criteria:

• Age >50 years, duration >2 weeks
• Bilateral shoulder or pelvic girdle aching, or both
• Morning stiffness duration of >45 min
• Evidence of an acute-phase response

Please remember that PMR can be diagnosed with normal inflammatory markers if there is a classic clinical picture and response to steroids. These patients should be referred for specialist assessment.