Fast track clinics -the future of PMR care?

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Over the past year we have implemented a fast track clinic for PMR at our institution in Dublin. Patients are referred predominantly from primary care, and we aim to see patients within a one to two week window. Without a doubt, patient outcomes are far superior with the instigation of the fast track clinic as part of our service.

Choosing steroid sparing therapies in PMR

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Despite the official recognition of PMR as a distinct disease more than 60 years ago, patients with PMR are still largely treated with steroids (glucocorticoids, mostly prednisone). The persistent broad use of glucocorticoids in PMR is related to their quick initial efficacy in the majority of patients with PMR, their low price and the lack of alternative treatments and paucity of glucocorticoid-sparing treatments.

Blinkers and the Unseen Information Gap in PMR

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In my earlier blog, PMR: glad or bad tidings? I mentioned our PMR Voices 2021 public engagement project. This project brought home to me as a physician that although our expertise is essential, one unfortunate side-effect is that our very expertise can give us “blinkers”. One result of our “blinkers” is that we may fail to see the extent of the information gap between us and our patients with newly-diagnosed PMR. 

JAMA Review of Knee Pain: - 5% PCP visits for knee pain: - Knee #OA: 654 mill worldwide, mostly >45 yrs age - Patellofemoral OA: < 40 yrs age; Sx: ant knee pain w/ squat - Meniscal tears: 12% adults < 40 yrs; dx by McMurray test & joint line tenderness https://t.co/kf1OOiwIR4 https://t.co/e5hiodDZgn