Polymyalgia rheumatica/giant cell arteritis in a Cambridge general practice.

Abstract

The aim of this study was to establish the incidence and prevalence of polymyalgia rheumatica/giant cell arteritis in general practice. Patients with this disorder, whether previously diagnosed or not, were ascertained by using a questionnaire administered by interview, and all received full clinical and laboratory assessment. A total of 579 patients aged 65 and over was seen, and 19 (33/1000) had been diagnosed or developed symptoms within the previous eight years. Thus the calculated annual incidence in those aged 65 and over was about 4/1000. The figures from this first large scale study of polymyalgia rheumatica/giant cell arteritis in general practice are much higher than those from studies carried out in hospital. The questionnaire was effective in both identifying known cases of polymyalgia rheumatica/giant cell arteritis and detecting new cases. As this is a treatable disorder, it is important that doctors become aware of how common it is in elderly people.

Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990-2001

“…The first identified nine new cases of TA over a period of 4K years in the early 1950s, with an estimated incidence of 5.4/10 000 person-years 4 The second identified 19 incident cases of either PMR or TA during the late 1970s and early 1980s and estimated the annual incidence among people aged 65 years and over to be 40/ 10 000. 5 Both these estimates were somewhat higher than the incidences we obtained, but were derived from small localised populations.…”

“…The two previous published studies of incidence of these conditions in the United Kingdom come from single general practices. 4 5 We investigated time trends and regional variation in the incidence of the diagnosis of PMR and TA using data obtained from the UK General Practice Research Database (GPRD).…”

Atypical presentations of polymyalgia rheumatica

“…Although an elevated ESR is helpful in establishing a diagnosis of PMR, it is now accepted that this is not a necessity (5,6). Patients 4 and 6 had consistently normal ESRs.…”

“…The annual incidence of PMR in individuals aged 65 and over has been calculated to be as high as 4 cased1 ,000 per year (6). Systemic features include low-grade fever, weight loss, malaise, and fatigue.…”

043. The Prevalence of Giant Cell Arteritis and Polymyalgia Rheumatica in a UK Primary Care Population

“…The diagnosis could be confirmed or refuted by later applying clinical judgement during a patient visit. A new questionnaire was developed by adapting the 1985 questionnaire used by Kyle et al [5], to Age ≥ 50 years >1 month of neck, shoulder, or pelvic girdle pain (any two areas); morning stiffness >1 h; exclusion of other diagnoses ESR ≥40 mm/h Rapid response to daily, low-dose steroid therapy (i.e., prednisolone ≤20 mg)…”