title: Cautious use of steroids to ease the pain of polymyalgia rheumatica is vital.
abstract: Polymyalgia rheumatica is almost never seen in people under the age of 50; average onset is just over the age of 70 with 75 per cent of patients being women. The most typical presenting feature is bilateral shoulder pain and stiffness with bilateral upper arm tenderness. Patients often also develop hip girdle and neck pain and stiffness. Most patients also have systemic symptoms such as fatigue, loss of appetite, low grade fever and depression.