Polymyalgia rheumatica >50 yrs age, 15% develops Giant cell arthritis
Pain, fever, malaise, wt loss
Pain / stiffness > weakness : shoulders, pelvic girdle Anemia, sedrate>30-40 CPR >0.5 Pain in different parts: neck, buttocks, hips, thighs with limited range of movement + stiffness in the morning with limited range of motion for 1 hour. S/S > 1 month, 2 diff areas
Testing: RA factor, Sed rate / CRP, CBC w diff, Comprehensive metabolic panel,Ca , alkaline phosphatase, PEP protein electrophoresis, CK creatinine Kinase, VIT D, ANA, ANCA : Anti-cytoplasmic neutrophil antibodies, TB test, Chest X-ray , UA urinalysis, TA ultrasound, TA artery biopsy
Rx: Short term NSAIDs, Prednisone low dose 10-20 mg/d for months to years. Methotrexate can be used to lower prednisone. Will be able d/c prednisone in 2-4 yrs.
I need help on this.
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