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The Deceased Nation of New Jamisonia
65 days ago
The way to diagnose Polymyalgia Rheumatica vs Temporal arteritis, has always been a bit obscure to me. I kinda see as a corollary to Crohns vs Ulcerative colitis. TA happens in older men, 70s and above, jaw claudication, one-sided sharp pain in the eye, redness and swelling with headache and severe arterial inflammation. Need quick steroids. PMR is diagnosed through stiffness of the axial muscles, shoulder and pelvic girdle. Both show inflammatory changes, but PMR is in younger people, m:f ratio is closer and it's abt more abt the rheumatology. TA is about the neuro-opthalmological signs. Both have high ESR, CRP and in TA with the red eye, immediate steroids and ophthal consult are a must or blindness may occur. A big chunk of the temporal artery must be biopsied because of the skip lesions (it's not contiguous)
Differentiating PMR from myositis is thru the normal CK. There is pain but no destruction of muscle and normal EMG
Mmm, this is fun...
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