Good afternoon, may I pick some of your brains please.Long story short for those who don't know me, put on Prednisolone last August after reporting heavy dragging burning aching in shoulders and arms. When bloods showed raised ESR a young GP registrar diagnosed PMR after a trial dose of P. erased the pain and discomfort.
The pains came and went to varying degrees and it was decided not PMR. I've been tapering from 15 mg pred for the last 6 months, up and down like a yo yo. (Apologies to those who have heard it all before).
Now my endo has taken over my case, I trust him and I feel safe, I'm seeing him in 5 weeks time. My question is whether the registrar was negligent in not checking with her supervising GP before prescribing the pred although the clock can't be turned back. It erased the pains but they came back while I was still taking it and that's when I was told I didn't have PMR and I had to stop taking the P. My endo has now advised a reduction from 7 to 6mg until I see him in 5 weeks which I am happy to do. Still not sure whether PMR is indicated or not 🤔
Thanks for listening, G.
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Groggrim
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It really is difficult to say but I really don't think the registrar was negligent. The response to pred is usually taken as part of the diagnostic process and what you described is fairly typical of PMR. That the symptoms returned was probably far more due to the way you were told to reduce the dose than that it wasn't PMR and similar errors are made by GPs old and young and rheumies as well. There is no definitive test for PMR and patients are mostly a bit impatient, wanting a solution for their pain asap so it isn't uncommon for someone to be given pred, good pain relief and happy patient and then noone would have complained.
What was your endo’s diagnosis? I was diagnosed by a nurse practitioner at my gp surgery and a rheumatologist I saw dismissed the diagnosis. I went with authority and my delay taking prednisone cost me very dearly. PET-CT almost a year later confirmed PMR and added large vessel involvement. I am glad you feel in good hands.
Hello, at the end of last year I saw my husband's rheumatologist privately who concurred with the GPs diagnosis. My endo has not queried it and has only recently got involved. I will have up to date blood tests before seeing him in 5:weeks' time so he will give me his valued opinion then. I have been with him for about six years for my autoimmune hypothyroidism and we get on well. Prior to that I was with a horrible man who made me cry in clinic one day. I refused to see him again and was transferred to this lovely professor of endocrinology called Professor Saravanan.
I was also diagnosed by a trainee GP. I was told that the symptoms, ruling out other similar things as far as possible, and response to pred were the tests. And the diagnosis was provisional as no definite simple test exists. I am not sure exactly how far GP registrars are independent during training, but they are experienced doctors, dont they have years in hospital first? I feel the diagnosis was likely right in my case, from how its behaved, but I would have gone back to her if the pain had come back and we could have reconsidered.
Thanks. From what I have learned here in the last six months I suspect I have a mild to moderate case of PMR. I had two aunts with it and I have other autoimmune issues. with the support here and the experience of my endo I expect the next six months and beyond to be better. Thanks for your reply 🙂
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Not understanding 
Opinions
Differing Rheumatologist opinions and Alendronic Acid
Is it back? 🙈
Help & advice please.
