Polymyalgia rheumatica and giant cell arteritis

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Abstract
Low doses of corticosteroid readily reverse the pain and stiffness of polymyalgia rheumatica, but only high doses can prevent the vascular complications of giant cell arteritis. The dilemma of therapy arises from the fact that giant cell arteritis can present subtly, with the same symptoms as polymyalgia rheumatica. Prescribing a high dose for all patients with such symptoms would certainly prevent vascular complications, but it would also put patients with polymyalgia rheumatica at needless risk of steroid side effects. In this article, Drs Wilske and Healey explain how to differentiate between these two inflammatory conditions on clinical and laboratory grounds so that the correct dose of steroid can be more confidently prescribed.

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