Polymyalgia Rheumatica and Temporal Arteritis

Abstract

In 29 patients with "polymyalgia rheumatica" (defined as central pains and stiffness and a raised E.S.R. [Erythrocyte sedimentation rate]), a temporal artery biopsy was positive for temporal arteritis in 10 and normal in 18; in one subject the artery could not be found. Absence of temporal artery pulsation and undue sensitivity of the carotid sinus to pressure were useful signs predicting a positive biopsy. These signs were validated by reference to control populations of 57 patients with advanced rheumatoid arthritis and 211 normal elderly men and women. A comparison of patients in whom the biopsy was positive with those in whom it was negative showed no difference with regard to sex, age at onset, duration of disease, or response to treatment, although there were differences in symptoms corresponding to involvement of the cranial arteries. It seems likely that polymyalgia rheumatica and temporal arteritis constitute a single entity which is commoner than is generally recognized.