Polymyalgia Rheumatica (PMR) & Giant Cell Arteritis (Temporal Arteritis)

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Catherine Burt Driver, MD
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

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What are symptoms of giant cell arteritis?

Because giant cell arteritis is commonly due to inflammation of the arterial blood vessels affecting the head, it frequently leads to headaches, pain in the jaw when repetitively chewing, and tenderness of the scalp (usually over the inflamed arteries of the sides of the head). It is also commonly associated with fatigue, low-grade fevers, and weight loss. The muscle aching of polymyalgia rheumatica is seen in nearly half of the patients with giant cell arteritis, either before, during, or after the onset of the arteritis.

When the arteries affected by giant cell arteritis become inflamed, they can narrow to the degree that the blood flow through them is limited. This can cause serious deficiency of oxygen supply to the tissues normally supplied by these arteries. Inadequate oxygenation of the eyes or brain can lead to impaired or double vision, blindness, or stroke. Less commonly, inflammation of the blood vessels supplying the arms can lead to arm pain when the arms are working.

How is giant cell arteritis diagnosed?

The diagnosis of giant cell arteritis is suspected when a patient over the age of 50 (usually over 60) develops symptoms above and/or suddenly develops blindness or stroke. The diagnosis is supported by signs of inflammation in the blood indicated by an elevation in the erythrocyte sedimentation rate and/or C-reactive protein.

The diagnosis is confirmed with a biopsy of an artery, usually an artery on the side of the scalp called the temporal artery. This biopsy is performed under local anesthesia in an outpatient setting. It requires an incision into the scalp over the artery in the skin. The tissue of this area is supplied by blood from many vessels and does just fine after removal of the piece of the artery.

Medically Reviewed by a Doctor on 3/7/2016

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