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Published on: September 15, 2016
The spectrum of polymyalgia rheumatica
1University of Washington School of Medicine, Seattle.
Clinics in Geriatric Medicine
|May 1, 1988
Summary
Polymyalgia rheumatica and temporal arteritis are common in older adults. Early prednisone treatment is key for polymyalgia rheumatica, while temporal arteritis requires higher doses after biopsy confirmation.
Area of Science:
- Rheumatology
- Internal Medicine
- Geriatrics
Background:
- Polymyalgia rheumatica and temporal arteritis are prevalent conditions affecting older Caucasians.
- Their etiology remains unknown, posing diagnostic challenges.
Purpose of the Study:
- To differentiate polymyalgia rheumatica from rheumatoid arthritis.
- To outline diagnostic and treatment strategies for temporal arteritis.
Main Methods:
- Clinical differentiation based on joint inflammation patterns.
- Response to low-dose prednisone for polymyalgia rheumatica.
- Temporal artery biopsy for definitive temporal arteritis diagnosis.
Main Results:
- Polymyalgia rheumatica is a benign synovitis responding well to small prednisone doses.
- Temporal arteritis occurs in 20% of polymyalgia rheumatica patients.
- High-dose prednisone for at least one month is recommended for confirmed temporal arteritis.
Conclusions:
- Polymyalgia rheumatica and temporal arteritis require distinct management approaches.
- Erythrocyte sedimentation rate is useful for initial suspicion but not for steroid dose tapering.
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