Polymyalgia rheumatica and giant cell arteritis
Description
- Two ends of one disease spectrum in people over 50
| PMR | GCA | |
|---|---|---|
| Lesion | Bursitis + synovitis of shoulder and hip girdles | Granulomatous panarteritis of large and medium arteries |
| Core symptom | Bilateral shoulder and hip girdle pain + stiffness | Headache, jaw claudication, visual loss |
| Risk | Disability, steroid toxicity | Irreversible blindness, aortic aneurysm |
- ~40-50% of GCA patients have PMR symptoms
- ~15-20% of PMR patients develop GCA
- *Always ask a PMR patient about headache, jaw claudication and visual symptoms - at every visit*
GCA phenotypes
- Cranial GCA - temporal/occipital headache, scalp tenderness, jaw claudication, visual loss
- Large-vessel GCA (LV-GCA) - aorta, subclavian, axillary; fever of unknown origin, limb claudication, absent pulses, constitutional symptoms without headache
- Younger, more female, more likely to be biopsy-negative, more aortic complications
6 more sections, plus exam facts
Premium unlocks every note across every specialty, and the full exam fact library behind it.
Get premium access