Polymyalgia Rheumatica and Temporal Arteritis

Polymyalgia rheumatica is a rare, inflammatory condition that causes pain or aching in the large muscle groups, especially around the shoulders and hips. Polymyalgia literally means "many muscle pains." Rheumatica means "changing" or "in flux."

What Are the Symptoms of Polymyalgia Rheumatica?

Symptoms tend to develop quickly and in addition to muscle pain, other symptoms may include the following:

• Stiffness, especially in the morning and after resting
• Weakness
• Fatigue
• Generally feeling ill
• Mild fevers (occasionally)
• Weight loss

What Is Temporal Arteritis?

About 15% of people with polymyalgia rheumatica also have temporal arteritis and about half of people with temporal arteritis also have polymyalgia rheumatica. Temporal arteritis causes inflammation that damages large and medium-sized arteries. The name of the condition stems from the fact that some of the affected arteries provide blood to the head, including the temples. Temporal arteritis is also known as "giant cell arteritis."

What Are the Symptoms of Temporal Arteritis?

Temporal arteritis has several symptoms, including:

• Severe headaches, the most common symptom.
• Scalp tenderness.
• Jaw or facial soreness, especially with chewing.
• Vision changes or distorted vision caused by decreased blood flow.
• Stroke may occur in less than 5% of patients and is caused by decreased blood flow.
• The large blood vessels may become narrowed or enlarged (aneurysm). If narrowing occurs in the blood vessels leading to the arms or legs, patients may notice fatigue or aching in the limbs, due to a reduced blood supply. Your doctor may notice weak or absent pulses.
• Other symptoms may include fever, weight loss, night sweats, depression, fatigue, and a general feeling of being ill.

Who Is Affected By Polymyalgia Rheumatica and Temporal Arteritis?

Polymyalgia rheumatica and temporal arteritis frequently affect the same types of people. People over 50 years old are most often affected. The average age of patients is 70. These diseases are more common among women, and Caucasians are more likely to get these diseases than other ethnic groups.

The exact cause of these illnesses is unknown.

How Are Polymyalgia Rheumatica and Temporal Arteritis Diagnosed?

If a doctor suspects polymyalgia rheumatica after hearing a patient's symptoms and the examination, then blood tests will likely be done to help confirm the diagnosis. The blood tests will help test for inflammation as well as help rule out other possible causes of the symptoms, such as rheumatoid arthritis or an underactive thyroid.

Everyone with polymyalgia rheumatica is also tested for temporal arteritis. This, too, would start with the examination and listening to the patient's symptoms.

If temporal arteritis is suspected, but less convincing features are present, a temporal artery biopsy may confirm the diagnosis. The biopsy is taken from a part of the artery located in the hairline, in front of the ear. In most cases the biopsy is helpful, but in some individuals it may be negative or normal, even though the person does have temporal arteritis.