MSRA: Giant Cell Arteritis + PMR

Question 1

What are the key investigations in Giant Cell Arteritis?

Answer 1

FBC
CRP and ESR
Temporal artery ultrasound/biopsy

Question 2

What is the ARA Criteria for the diagnosis of GCA?

Answer 2

Age >50
New headache
Abnormalities of the temporal arteries
ESR >50
Positive biopsy of temporal arteries

Question 3

What is the treatment of GCA?

Answer 3

Oral Prednisolone - most patients need 1-3years
40mg in uncomplicated
60mg in complicated
Can be reduced after 4 weeks if symptoms have improved and inflammatory markers have normalised

Question 4

What is meant by complicated temporal arteritis?

Answer 4

There is critical ischaemia

Jaw claudication, tongue claudication, visual disturbances

Question 5

What are the clinical features of PMR?

Answer 5

2 week history of core symptoms:

• Pain and stiffness in neck/shoulder/pelvic girdle
• Worse in the morning with 45 minutes of stiffness
• Constitutional symptoms may be present
• Muscle strength is not usually impaired

Question 6

What is the starting steroid dose in PMR?

Answer 6

15mg Prednisolone daily

Review 1 week after starting to assess clinical response