Large vessel vasculitises

Question 1

What is polymyalgia rheumatica and who tends to get it?

Answer 1

Middle aged and elderly patients

• Pain and stiffness in neck, shoulders and pelvic girdle that gets better as the day goes on
• Systemic features of malaise, weight loss and flu like symptoms

Question 2

What are the investigations treatment?

Answer 2

Raised ESR/CRP

Clinical diagnosis

Dramatic response to steroids

Question 3

What should you check for with PMR symptoms

Answer 3

Multiple myeloma via BJP

Question 4

What is PMR related to?

Answer 4

Giant cell (temporal) arteritis

Question 5

What is Giant cell arteritis?

Answer 5

It is the most common vasculitis affecting the aorta and large vessels, particularly the superficial temporal artery

Question 6

What are the symptoms of Giant Cell Arteritis?

Answer 6

PMR symptoms

Headaches and pain when touching scalp

Jaw claudication

Constitutional

Question 7

What are the investigations for Giant cell arteritis?

Answer 7

As for PMR to check inflammation

Biopsy to confirm

Pet scan for increased uptake in vessels

Question 8

What is the treatment for Giant cell arteritis?

Answer 8

High dose sterioids and aspirin for complications

Question 9

What are the complications of Giant cell arteritis?

Answer 9

Opthalmic artery involvement and blindess

MI

CVA