Polymyalgia rheumatica: An updated review

Cleve Clin J Med. 2020 Aug 31;87(9):549-556. doi: 10.3949/ccjm.87a.20008.


Polymyalgia rheumatica should be suspected in older patients with bilateral shoulder and hip stiffness that is worse in the morning and improves with use. An array of nonspecific musculoskeletal complaints, constitutional symptoms, and elevated serum inflammatory markers may be present, so other conditions should also be considered. Prolonged glucocorticoids with patient-tailored dosing and duration are the mainstay of treatment. Corticosteroid-sparing therapy with adjunctive methotrexate may benefit select patients.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Blood Sedimentation
  • Diagnosis, Differential
  • Female
  • Giant Cell Arteritis / diagnosis
  • Giant Cell Arteritis / etiology
  • Glucocorticoids / therapeutic use
  • Humans
  • Induction Chemotherapy
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Polymyalgia Rheumatica / complications
  • Polymyalgia Rheumatica / diagnosis*
  • Polymyalgia Rheumatica / drug therapy*
  • Ultrasonography


  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Glucocorticoids
  • tocilizumab
  • Methotrexate