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Flashcards in Polymyalgia Rheumatica Deck (11)
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1

Typical age group affected by polymyalgia rheumatica

>50yrs

2

Characteristic feature of polymyalgia rheumatica

proximal myalgia of the hip and shoulder girdles with accompanying morning stiffness for > 1 hour

3

What disease is polymyalgia rheumatica associated with?

giant cell arteritis - approx 15% develop GCA; 40-50% of GCA patients have PMR

4

Presenting features of polymyaglia rheumatica

Sore/stiff but no weakness, reduced movement due to pain, normal strength (no inflammation), fatigue, anorexia, weight loss and maybe fever, rapid onset (weeks)

5

Diagnosis of Polymyalgia Rheumatica

exclude other diagnosis - there are no autoantibodies for PMR. Blood tests - raised CRP, ESR and PV

6

Treatment of Polymyalgia Rheumatica

rapid and dramatic response to 15mg of prednisolone. This is reduced over an 18month period

7

Histological findings in giant cell arteritis

transmural inflammation across the intima, media and adventitia of the artery. There may be infiltration by lymphocytes, macrophages and multi-nucleated giant cells

8

Pathophysiology of giant cell arteritis

Vessel wall thickening leads to distal ischaemia

9

Signs and Symptoms of giant cell arteritis (4)

headache - temporal area; jaw claudication - tiredness/aching on chewing; visual loss - black curtain over one eye; tender, enlarged but non-pulsatile artery

10

Diagnosis of giant cell arteritis

temporal artery biopsy (which may be negative), raised inflammatory markers

11

Treatment of giant cell arteritis

no visual loss - 40mg prednisolone; with visual loss - 60mg of prednisolone --> taper dose over 18 months