Rheum – Polymyalgia Rheumatica & Giant Cell Arteritis

  • Over 50year olds only – Usually over 70yrs
  • Typically shoulder and hip girdle pain with marked stiffness
  • GCA is present in at around 30%
  • Steroids – pred 15-20mg / day is treatment – usually responds well to steroids (relatively low dose)
  • Taper steroids slowly and start on bisphosphonates and calcium
  • In relapses increase dose to previous level
  • First and second relapses can be managed like this, but third relapse should be referred to rheum for consideration of DMARD therapy.
  • Also can give IM methyl pred 120mg

 

GCA

  • Systemic vasculitis
  • Affects large and medium sized arteires