Polymyalgia Rheumatica Flashcards
how is polymyalgia rheumatica characterized?
inflammatory pain and stiffness in the shoulder and hip girdles
what is polymyalgia rheumatica associated with in 30% of cases?
giant cell arteritis
when is pain and stiffness the most severe in polymyalgia rheumatica? (2)
after rest
in the morning
what are te 3 characteristics of musculoskeletal symptoms in polymyalgia rheumatica?
bilateral
proximal
symmetrical
what are the 6 symptoms of polymyalgia rheumatica?
“SHAN F has polymyalgia rheumatica”
Shoulder pain
Hip pain
Anorexia/weight loss
Neck pain
Fever/Fatigue
what will labs show to diagnose polymyalgia rheumatica?
markedly elevated inflammatory markers
ESR > 30
CRP > 0.5
what is the treatment for polymyalgia rheumatica? (3)
corticosteroids
+/- methotrexate
+/- Anti-IL6 meds
when is response from corticosteroid treatment expected for polymyalgia rheumatica?
1-7 days
how is giant cell arteritis characterized?
granulomatous vasculitis of the aorta and main aortic branches
what sized vessels are affected by giant cell arteritis?
medium + large vessels
what is the most common form of vasculitis in adults?
giant cell arteritis
what are the symptoms of giant cell arteritis?
“everything in CHASTU’s head hurts”
Claudication of the jaw
Headache
Amaurosis fugax (visual symptoms)
Scalp tenderness
Temporal artery tenderness
Unexplained Fever
what are some diagnostics present in giant cell arteritis?
“TEN/10 pain”
high inflammatory markers
ESR > 50
elevated CRP
Thrombocytosis
Elevated Alkaline Phosphatase
Normochromic anemia
what imaging will establish a diagnosis of giant cell arteritis? what will it show?
MRA/CTA
long stretches of narrowing, thickening, or aneurysmal dilation of aorta
what is the gold standard/most specific test to diagnose giant cell arteritis?
biopsy of temporal artery