Polymyalgia rheumatica
Pathophysiology
Features
Investigations
Treatment
- overlaps with temporal arteritis
- histology shows vasculitis with giant cells, characteristically 'skips' certain sections of affected artery whilst damaging others
- muscle bed arteries affected most in polymyalgia rheumatica
Features
- typically patient > 60 years old
- usually rapid onset (e.g. < 1 month)
- aching, morning stiffness in proximal limb muscles (not weakness)
- also mild polyarthralgia, lethargy, depression, low-grade fever, anorexia, night sweats
Investigations
- ESR > 40 mm/hr
- note CK and EMG normal
- reduced CD8+ T cells
Treatment
- prednisolone e.g. 15mg/od - dramatic response