Questions and Answers about Polymyalgia Rheumatica and Giant Cell Arteritis
How Are Polymyalgia Rheumatica and Giant Cell Arteritis Diagnosed? continued...
Before making a diagnosis of polymyalgia rheumatica, the doctor
may order additional tests. For example, the C-reactive protein test is another
common means of measuring inflammation. There is also a common test for
rheumatoid factor, an antibody (a protein made by the immune system) that is
sometimes found in the blood of people with rheumatoid arthritis. While
polymyalgia rheumatica and rheumatoid arthritis share many symptoms, those with
polymyalgia rheumatica rarely test positive for rheumatoid factor. Therefore, a
positive rheumatoid factor might suggest a diagnosis of rheumatoid arthritis
instead of polymyalgia rheumatica.
As with polymyalgia rheumatica, a diagnosis of giant cell
arteritis is based largely on symptoms and a physical examination. The exam may
reveal that the temporal artery is inflamed and tender to the touch, and that
it has a reduced pulse.
Any doctor who suspects giant cell arteritis should order a
temporal artery biopsy. In this procedure, a small section of the artery is
removed through an incision in the skin over the temple area and examined under
a microscope. A biopsy that is positive for giant cell arteritis will show
abnormal cells in the artery walls. Some patients showing symptoms of giant
cell arteritis will have negative biopsy results. In such cases, the doctor may
suggest a second biopsy.
How Are They Treated?
The treatment of choice for both polymyalgia rheumatica and
giant cell arteritis is corticosteroid medication, usually prednisone.
Polymyalgia rheumatica responds to a low daily dose of
prednisone that is increased as needed until symptoms disappear. At this point,
the doctor may gradually reduce the dosage to determine the lowest amount
needed to alleviate symptoms. Most patients can discontinue medication after 6
months to 2 years. If symptoms recur, prednisone treatment is required
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin
and ibuprofen (Advil, Motrin*), also may be used to treat polymyalgia rheumatica.
The medication must be taken daily, and long-term use may cause stomach
irritation. For most patients, NSAIDs alone are not enough to relieve
Even without treatment, polymyalgia rheumatica usually
disappears in 1 to several years. With treatment, however, symptoms disappear
quickly, usually in 24 to 48 hours. If prednisone doesn’t bring improvement,
the doctor is likely to consider other possible diagnoses.