[Polymyalgia rheumatica and giant cell arteritis: what's new?].
Polymyalgia rheumatica (PMR) and temporal arteritis (TA) are 2 common conditions in the elderly patient. Early diagnosis and rapid introduction of treatment with corticosteroids is critical, in order to avoid potentially serious complications. The diagnosis is largely clinical for PMR, whereas it is both clinical and histopathological for TA. Certain situations may require complementary investigations such as ultrasound or PET-CT. Bilateral subacromial/subdeltoid bursitis is extremely frequent in patients with PMR, but rarely present in healthy subjects. Intravenous bolus corticosteroids may be useful at presentation with TA, particularly when associated with visual symptoms. There may be a role for disease-modifying antirheumatic drugs (DMARD) such as methotrexate in reducing the requirement for corticosteroids. Finally, clinical and radiological follow-up is important in order to detect aortic aneurysms or large vessel involvement.
Nissen
Michael J
MJ
Service de rhumatologie, Département de médecine interne, HUG, 1211 Genève 14. michael.j.nissen@hcuge.ch
Gabay
Cabay
C
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D002062:Bursitis / Q000150:complications / Q000453:epidemiology; D013700:Giant Cell Arteritis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D011111:Polymyalgia Rheumatica / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
D000305:Adrenal Cortex Hormones; D018501:Antirheumatic Agents