Muscle Pain in Systemic Inflammation (Polymyalgia Rheumatica, Giant Cell Arteritis, Rheumatoid Arthritis)

2012 ◽  
Keyword(s):  
Rheumatoid Arthritis ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Systemic Inflammation ◽  
Polymyalgia Rheumatica ◽  
Muscle Pain

scholarly journals Hla–drb1 alleles in polymyalgia rheumatica, giant cell arteritis, and rheumatoid arthritis

1994 ◽  
Vol 37 (4) ◽  
pp. 514-520 ◽  
Author(s):  
Cornelia M. Weyand ◽  
Naomi N. H. Hunder ◽  
Kevin C. Hicok ◽  
Gene G. Hunder ◽  
Jörg J. Goronzy
Keyword(s):  
Rheumatoid Arthritis ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica

scholarly journals AB1303-HPR TIME UNTIL DIAGNOSIS IN RHEUMATOLOGICAL PRACTICE: RESULTS FROM A CROSS-SECTIONAL MIDDLE-EUROPEAN COHORT COMPARED TO DATA FROM A SYSTEMATIC LITERATURE REVIEW

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1942.1-1942
Author(s):  
R. Mc-Cutchan ◽  
S. Maier ◽  
V. Winkler ◽  
B. Gruber ◽  
M. Schirmer
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Literature Review ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Systematic Literature Review ◽  
Polymyalgia Rheumatica ◽  
Diagnostic Delay ◽  
Inflammatory Rheumatic Diseases ◽  
Diagnostic Delays

Background:The time from first symptom to diagnosis (= diagnostic delay) is considered as key factor for better outcome in many chronic inflammatory rheumatic diseases, especially for rheumatoid arthritis (RA) and vasculitides like giant cell arteritis (GCA). A longer diagnostic delay may cause pain, reduced functionality, reduced life-quality and increased morbidity, as well as structural damages of the organs linked with higher mortality. This retrospective study assessed the diagnostic delay in consecutive Middle-European outpatients and compared results with those of a systematic literature review (SLR).Objectives:To compare disease-specific diagnostic delays of consecutive rheumatic patients with international data from a systematic literature review.Methods:Charts of a single-centre cohort with consecutively recruited patients were retrospectively reviewed for patients’ and diseases’ characteristics at a Middle-European university outpatient clinic for rheumatology. A SLR was performed according to PRISMA guidelines.Results:The average mean ± SD time from first symptom to established diagnosis was 7.9 ± 11.7 (0.02-56.7) years. Spondyloarthritis patients showed the longest diagnostic delay with 13.1 ± 14.2 (0.1-56.7) years, whereas polymyalgia rheumatica-patients had the shortest diagnostic delay with 1.5 ± 0.4 (0.3-18.0) months. In the SLR, most data for diagnostic delays are comparable to the Innsbruck cohort, but the diagnostic delay for psoriatic arthritis in Innsbruck is longer than in the Danish DANBIO registry (p<0.001). Independent risk factors for prolonged diagnostic delays could not be identified.Conclusion:For this Middle-European area, initiatives are justified especially to shorten diagnostic delays of SpA and PsA.References:[1]O’Dell JR. Treating rheumatoid arthritis early: A window of opportunity? Arthritis Rheum. 2002;46:283–5.[2]Seo MR, Baek HL, Yoon HH, Ryu HJ, Choi HJ, Baek HJ, et al. Delayed diagnosis is linked to worse outcomes and unfavourable treatment responses in patients with axial spondyloarthritis. Clin Rheumatol. 2015;34:1397–405.[3]Diagnostic delay of more than 6 months contributes to poor radiographic and functional outcome in psoriatic arthritis. Ann Rheum Dis. 2015;74:1045–50.[4]Dejaco C, Brouwer E, Mason JC, Buttgereit F, Matteson EL, Dasgupta B. Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities. Nat Rev Rheumatol. Nature Publishing Group; 2017;13:578–92.Acknowledgments:We acknowledge and thank all patients who could be recruited to the SolutionX project. Ethical vote was obtained by the local ethics committee of the Medical University of Innsbruck (AN2017-0041 370/4.18).Disclosure of Interests:Rick Mc-Cutchan: None declared, Sarah Maier: None declared, Valentin Winkler: None declared, Bernhard Gruber: None declared, Michael Schirmer Grant/research support from: total <3000.- €, Speakers bureau: total <3000.- €

scholarly journals Giant cell arteritis with cervical radiculopathy mimicking polymyalgia rheumatica and elderly-onset rheumatoid arthritis: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Akihiko Nakabayashi ◽  
Hiroki Ikai ◽  
Yoshinori Katada
Keyword(s):  
Rheumatoid Arthritis ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Neurological Examination ◽  
Polymyalgia Rheumatica ◽  
Clinical Symptoms ◽  
Cervical Radiculopathy ◽  
Upper Limbs ◽  
Elderly Onset ◽  
Elderly Onset Rheumatoid Arthritis

Abstract Background Giant cell arteritis has a wide variety of clinical symptoms, one of them being cervical radiculopathy, which mainly involves the C5 nerve root. If the patient does not develop typical clinical symptoms of giant cell arteritis but has C5 radiculopathy, it may be misdiagnosed as polymyalgia rheumatica or elderly-onset rheumatoid arthritis due to old age, high serum inflammatory markers, and difficulty in raising both upper limbs. Case presentation A 72-year-old Japanese man with a month-long history of dyspnea on exertion and with difficulty in raising both upper limbs was referred to our hospital because of elevated serum C-reactive protein (12.62 mg/dL). He had no typical symptoms of giant cell arteritis such as headache, jaw claudication, visual loss, and fever. The patient tested negative for rheumatoid factor and anti-cyclic citrullinated peptide antibody, and matrix metalloproteinase-3 was within the normal range (54.3 ng/mL). Musculoskeletal ultrasound examination showed absence of tenosynovitis, bursitis, and synovitis, and the patient did not meet the classification criteria of polymyalgia rheumatica or rheumatoid arthritis; hence, those two diseases were unlikely. A precise neurological examination suggested bilateral C5 and C6 anterior radiculopathy and left C4 radiculopathy. Since cervical magnetic resonance imaging showed no mechanical causality, cervical radiculopathy of unknown origin was suggested. Fluorodeoxyglucose positron emission tomography/computed tomography revealed increased fluorodeoxyglucose lineal uptake along the vessel walls, including temporal arteries, vertebral arteries, and axillary arteries. Results of the biopsy of the left superficial temporal artery were compatible with giant cell arteritis. He was successfully treated with 30 mg of prednisolone, and both upper limbs could be elevated. Conclusions If the patient was misdiagnosed with polymyalgia rheumatica or elderly-onset rheumatoid arthritis based on only clinical symptoms and laboratory data, his symptoms might not improve due to insufficient steroid dose and vascular complications may occur later. Although rare, peripheral neuropathy in giant cell arteritis may include cervical radiculopathy. The musculoskeletal ultrasound and precise neurological examination were the turning points for the diagnosis of this case, and making a careful diagnosis using these methods was important.

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