Question

A 69-year-old woman presents with proximal muscle pain and stiffness in shoulders and hips, worse in the morning. ESR is 80 mm/h. There are no neurological deficits. Temporal arteries are non-tender. What is the most appropriate initial treatment?

Accepted Answer

Low-dose prednisolone (approximately 15 mg daily) with review

Answer

High-dose NSAIDs

Answer

High-dose prednisolone (60 mg daily) immediately

Answer

Methotrexate monotherapy

Answer

Physiotherapy alone

Practice question

A 69-year-old woman presents with proximal muscle pain and stiffness in shoulders and hips, worse in the morning. ESR is 80 mm/h. There are no neurological deficits. Temporal arteries are non-tender. What is the most appropriate initial treatment?