Who is Typically Diagnosed with Polymyalgia Rheumatica
Polymyalgia rheumatica (PMR) is diagnosed almost exclusively in adults over age 50, with peak incidence around age 75, and affects women 2-3 times more frequently than men. 1, 2
Age Demographics
- PMR occurs only in individuals aged 50 years or older - this is a defining characteristic of the disease 2, 3, 4
- The median age at diagnosis is 75 years (interquartile range 69-79 years) 5
- Age under 60 years is considered an atypical presentation that warrants specialist referral, as it raises concern for alternative diagnoses 1, 6
Sex Distribution
- Women comprise approximately 75% of PMR cases, making female sex a strong demographic predictor 5
- Female patients are 2-3 times more likely to develop PMR compared to men 2
- Female sex is associated with higher risk of glucocorticoid-related side effects and potentially longer treatment duration 1
Incidence Rates
- The overall annual incidence is 11.3 per 10,000 patients aged 50 or over in primary care populations 5
- PMR is the most common inflammatory rheumatic disease affecting people older than 50 years 2
- It ranks as the second most common inflammatory rheumatic condition in the elderly, after rheumatoid arthritis 7
Important Clinical Caveat
A critical pitfall to avoid: While age ≥50 is a defining feature, approximately 11% of patients may present with normal inflammatory markers (ESR/CRP), yet still have genuine PMR 5. This challenges the traditional diagnostic paradigm and means you cannot exclude PMR based solely on normal inflammatory markers in the appropriate clinical context. However, low inflammatory markers in a patient under 60 should prompt immediate specialist referral as this represents a highly atypical presentation 1, 6.