Polymyalgia rheumatica and temporal arthritis

Am Fam Physician. 2000 Aug 15;62(4):789-96, 801.

Abstract

Polymyalgia rheumatica and temporal arteritis are closely related inflammatory conditions that affect different cellular targets in genetically predisposed persons. Compared with temporal arteritis, polymyalgla rheumatica is much more common, affecting one in 200 persons older than 50 years. Temporal arteritis, however, is more dangerous and can lead to sudden blindness. The diagnosis of polymyalgia rheumatica is based on the presence of a clinical syndrome consisting of fever, nonspecific somatic complaints, pain and stiffness in the shoulder and pelvic girdles, and an elevated erythrocyte sedimentation rate. Temporal arteritis typically presents with many of the same findings as polymyalgia rheumatica, but patients also have headaches and tenderness to palpation over the involved artery. Arterial biopsy usually confirms the diagnosis of temporal arteritis. Early diagnosis and treatment of polymyalgia rheumatica or temporal arteritis can dramatically improve patients' lives and return them to previous functional status. Corticosteroid therapy provides rapid and dramatic improvement of the clinical features of both conditions. Therapy is generally continued for six to 24 months. Throughout treatment, clinical condition is assessed periodically. Patients are instructed to see their physician immediately if symptoms recur or they develop new headache, jaw claudication or visual problems.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Age of Onset
  • Aged
  • Anti-Inflammatory Agents / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Biopsy
  • Blood Sedimentation
  • Diagnosis, Differential
  • Female
  • Giant Cell Arteritis / diagnosis*
  • Giant Cell Arteritis / drug therapy*
  • Giant Cell Arteritis / epidemiology
  • Giant Cell Arteritis / etiology
  • Humans
  • Patient Education as Topic
  • Polymyalgia Rheumatica / diagnosis*
  • Polymyalgia Rheumatica / drug therapy*
  • Polymyalgia Rheumatica / epidemiology
  • Polymyalgia Rheumatica / etiology
  • Steroids

Substances

  • Anti-Inflammatory Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Steroids