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Flashcards in Polymyalgia Rheumatica Deck (11)
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Typical age group affected by polymyalgia rheumatica



Characteristic feature of polymyalgia rheumatica

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


What disease is polymyalgia rheumatica associated with?

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


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)


Diagnosis of Polymyalgia Rheumatica

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


Treatment of Polymyalgia Rheumatica

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


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


Pathophysiology of giant cell arteritis

Vessel wall thickening leads to distal ischaemia


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


Diagnosis of giant cell arteritis

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


Treatment of giant cell arteritis

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