Polymyalgia Rheumatica Flashcards
what group of people does polymyalgia rheumatica occur in
occurs almost exclusively in those >50y/o and occurs more often in more northern regions
what conditions is polymyalgia rheumatic associated with
associated with temporal arteritis and giant cell arteritis
around 15%
what is the key presenting feature of polymyalgia rheumatica
muscle stiffness, especially in morning
what muscles does polymyalgia affect
proximal muscles, eg hips, shoulder
similar to myositis
what are some systemic effects of polymyalgia rheumatica
fatigue, anorexia, weight loss, fever
what are the clinical features of polymyalgia
ache in shoulder and hip girdle, muscle(morning) stiffness, reduced movement of shoulder, neck and hip
describe how muscle strength is affected in polymyalgia rheumatica
muscle strength is normal
describe what temporal/giant cell arteritis is
granulomatous arteritis of large vessels
temporal if in temporal region of skull
what are some of the clinical features of temporal/giant cell arteritis
headaches, scalp tenderness, jaw claudication, visual loss
what effect does temporal/giant cell arteritis have on the temporal arteries
they become tender, enlarged and are non-pulsatile
what inflammatory markers indicate both polymyalgia rheumatica and temporal/giant cell arteritis
raised ESR, raised plasma viscosity and raised CRP
what tests other than inflammatory markers are used to diagnose temporal/giant cell arteritis
temporal artery biopsy, temporal artery ultrasound scan
what treatment is used for both polymyalgia rheumatica and temporal/giant cell arteritis
a gradually reducing long-term steroid dose, over 18 months to 2 years
how do polymyalgia and temporal arteritis respond to steroid treatment
both have rapid and dramatic response to low steroid dose, within a day or 2 patients usually feel fine
what steroid is used in treatment of polymyalgia and temporal/giant cell arteritis
prednisolone
