Polymyalgia Rheumatica And Giant Cell Arteritis

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Topic Overview

What are polymyalgia rheumatica and giant cell arteritis?

Polymyalgia rheumatica and giant cell arteritis are inflammatory problems.

In polymyalgia rheumatica (say “paw-lee-my-AL-juh roo-MAT-ih-kuh”), the joints and the areas around them get stiff and may ache. It mostly happens in the neck, shoulders, and hip.

In giant cell arteritis (say “ar-tuh-RY-tus”), inflammation occurs in the blood vessels that carry blood up through the neck to the head. It mostly affects the arteries that carry blood to the eyes, temple, and jaw.

Polymyalgia rheumatica and giant cell arteritis often occur at the same time and affect the same groups of people. Experts believe that the two problems are linked.^{1 2}

• They can occur before each other, after each other, or at the same time.
• About half of people with giant cell arteritis also have symptoms of polymyalgia rheumatica.
• People with polymyalgia rheumatica can also have giant cell arteritis.

Polymyalgia rheumatica is more common, but giant cell arteritis is more dangerous because it can cause loss of vision and may lead to a stroke or mini-strokes. People who have it need treatment right away.

What causes polymyalgia rheumatica and giant cell arteritis?

Experts don't fully understand the cause of these conditions. It may be that the body's defense system (immune system) is attacking the body’s own tissues. Your genes may play a role in this. For example, people whose ancestors are from Scandinavia or Northern Europe are more likely to have these problems. ^{2 3}

What are the symptoms?

Symptoms of polymyalgia rheumatica often start suddenly and get worse without treatment. The problem can cause:

• Muscle pain and morning stiffness in the neck, shoulders, and hip area.
• Tiredness and lack of energy.
• A low fever.
• Weight loss.

Symptoms of giant cell arteritis can start either suddenly or slowly. This problem needs treatment right away, because it can cause blindness, a stroke, or mini-strokes. Symptoms include:

• Vision problems.
• A severe headache, often near the temple or around the eye.
• Tenderness of the temple or scalp.
• Pain or aching of the tongue or jaw.

How are polymyalgia rheumatica and giant cell arteritis diagnosed?

Your doctor will do a physical exam and ask you about your symptoms and past health. He or she may suggest blood tests to find out if you have the conditions. Your doctor will have to rule out arthritis, because the symptoms are similar. To see if you have giant cell arteritis, a surgeon may take a sample (biopsy) from a blood vessel on your temple and test it for inflammation.

How are they treated?

Your doctor will give you steroid medicines to treat the inflammation. Most of the time, symptoms improve quickly and go away 2 to 4 weeks after treatment begins. After this, most people need to continue to take steroid medicines for 1 to 2 years or sometimes longer. This helps to control symptoms and to prevent the problems from coming back.

Steroid medicines can cause your bones to thin (osteoporosis). Calcium is important for keeping your bones strong. So you need to make sure you are getting enough calcium, enough vitamin D, and enough exercise to strengthen your bones. Your doctor may also give you a medicine to prevent bone thinning.

Who gets polymyalgia rheumatica and giant cell arteritis?

These problems most often occur after the age of 60. The average age for giant cell arteritis to occur is about 70. And about 80 out of 100 cases occur in women.³

Frequently Asked Questions

Last updated:	May 08, 2007
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	E. Gregory Thompson, MD - Internal Medicine, Stanford M. Shoor, MD - Rheumatology
Editors:	Kathe Gallagher, MSW, Pat Truman, MATC