Background: Polymyalgia rheumatica is often diagnosed and treated in general practice. Rheumatologists have expressed concern about overdiagnosing and steroid treatment that conceals other diseases and deteriorating osteoporosis.

Methods: A ten-year material (1985-94) of polymyalgia rheumatica from a Norwegian general practice.

Results: Six out of 54 patients with the diagnosis polymyalgia rheumatica had their diagnose changed after one year. Average prednisolone starting dose was 31 mg, median treatment time for women was 20 months and for men 29 months. 10% were treated more than ten years, and 20% relapsed. Patients with fractures in the follow-up period had longer treatment periods; this indicates that a shorter treatment time may be important in preventing osteoporosis.

Conclusions: Diagnosing polymyalgia rheumatica can be done in general practice if there is good communication with second-line medical-services in cases with indistinct or serious symptoms. It is important to have in mind temporal arteritis, rheumatoid arthritis and malignancies. Treatment and follow-up of these patients is a task that needs stable and continuous relations between patient and doctor with special focus on the osteoporosis problem.