From the Guidelines
The specialty that typically follows a diagnosis of Polymyalgia Rheumatica (PMR) is Rheumatology. After a PMR diagnosis, patients should be referred to a rheumatologist for specialized care and management, as recommended by the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) collaborative initiative 1. The initial treatment usually involves oral glucocorticoids, and rheumatologists are best equipped to manage PMR due to their expertise in inflammatory conditions, their ability to distinguish PMR from similar conditions, and their experience with the long-term management of steroid therapy and its potential complications. Some key aspects of PMR management include:
- Basic and follow-up investigations of patients under treatment
- Risk factor assessment
- Medical access for patients and specialist referral
- Treatment strategies such as initial glucocorticoid doses and subsequent tapering regimens, as outlined in the 2015 EULAR/ACR recommendations 1 Rheumatologists monitor for disease activity, medication side effects, and potential complications like giant cell arteritis, and may also prescribe supplements to prevent steroid-induced osteoporosis. The 2015 EULAR/ACR recommendations 1 provide a framework for the management of PMR, and rheumatologists should follow these guidelines to ensure optimal care for their patients. Key considerations in the management of PMR include the balance between desirable and undesirable effects, patients’ and clinicians’ values and preferences, and resource use, as emphasized in the 2015 EULAR/ACR recommendations 1.
From the Research
Specialty Following PMR Diagnosis
The specialty that typically follows a PMR diagnosis is rheumatology, as PMR is a rheumatic disease that requires management and treatment by a rheumatologist.
- Rheumatologists are responsible for diagnosing and treating PMR, as well as managing associated conditions such as giant cell arteritis (GCA) 2, 3.
- Primary care physicians may also be involved in the management of PMR, particularly in the initial diagnosis and treatment phases 4.
- In some cases, other specialists such as orthopedic surgeons or physical medicine and rehabilitation (PM&R) physicians may be consulted to address specific symptoms or complications related to PMR.
Associated Conditions and Specialties
PMR is often associated with other conditions, such as GCA, which may require consultation with additional specialists.
- Ophthalmologists may be involved in the management of GCA-related eye symptoms 2.
- Other specialists, such as orthopedic surgeons or pain management specialists, may be consulted to address specific symptoms or complications related to PMR or associated conditions.
Treatment and Management
The treatment and management of PMR typically involve a multidisciplinary approach, with rheumatologists playing a key role.