[Polymyalgia rheumatica. A disease in general practice]

In retrospective investigation from a group practice with 4,100 registered patients, the number of cases of giant cell arthritis (polymyalgia rheumatica and temporal arteritis) diagnosed during the period 1978-1988 was calculated. Possible diagnostic criteria and a proposal for a therapeutic plan are discussed. Twenty-eight patients (40% men and 60% women) participated in the investigation. This gives an incidence of 0.56/1,000 which is higher than in previous Danish investigations. Problems involved in excluding infectious diseases and malignant conditions are illustrated by means of a review of the reasons for consultation, the examinations performed and the treatments during a period of six months prior to commencement of steroid therapy. The diagnostic delay was found to be two months. 35% of the patients were hospitalized in the course of the disease. The average duration of treatment was 22.5 months. The importance of good information to the patients and the necessary of good cooperation between general practice and the hospital sector is emphasized.