Your answers to questions, a general physical exam and the results of tests can help your doctor determine the cause of pain and stiffness.
Your doctor will conduct an exam to get an idea of your overall health, identify possible causes or rule out certain diseases. He or she may gently move your head and limbs to judge how much your symptoms affect your range of motion.
A nurse or assistant will draw a sample of your blood. This sample will be used for several laboratory tests that your doctor will order. Typically, your doctor will check the complete blood counts (CBC) and for signs of inflammation, but your doctor also may recommend additional tests to rule out other conditions that have similar symptoms to polymyalgia rheumatica.
Test results helpful in making a diagnosis of polymyalgia rheumatica include the following:
- Sed rate (erythrocyte sedimentation rate), measures the distance red blood cells, or erythrocytes (uh-RITH-roh-sites), fall in a test tube in one hour. The distance indirectly measures the level of inflammation — the farther the red blood cells have descended, the greater the inflammatory response of your immune system. An increased rate occurs because of certain changes to red blood cell properties in response to inflammation.
- C-reactive protein test measures the concentration of C-reactive proteins in your blood. A high concentration of C-reactive protein indicates increased inflammation.
Your doctor may use magnetic resonance imaging (MRI) or ultrasound imaging to find inflammation of tissues within the shoulder and hip joints that can support a diagnosis of polymyalgia rheumatica. These images may also help identify or rule out other causes of your symptoms. Ultrasound imaging uses sound waves to produce images, while MRI relies on radio waves and a magnetic field to create images. Neither procedure exposes you to radiation.
Monitoring for giant cell arteritis
Your doctor will monitor you for signs or symptoms that may indicate the onset of giant cell arteritis. Talk to your doctor immediately if you experience any of the following symptoms:
- New, unusual or persistent headaches
- Jaw pain or tenderness
- Blurred or double vision or visual loss
- Scalp tenderness
If your doctor suspects a diagnosis of giant cell arteritis, he or she will order a biopsy of the artery in one of your temples. This procedure, performed during local anesthesia, removes a tiny sample of the artery, which is then examined in a laboratory for signs of inflammation.
Jul. 20, 2012
- Hunder GG. Clinical manifestations and diagnosis of polymyalgia rheumatica. http://www.uptodate.com/index. Accessed May 9, 2012.
- Salvarani C, et al. Polymyalgia rheumatica and giant-cell arteritis. The Lancet. 2008;372:234.
- Gonzalez-Gay MA, et al. Medical management of polymyalgia rheumatica. Expert Opinion in Pharmacotherapy. 2010;11:1077.
- Hunder GG. Treatment of polymyalgia rheumatica. http://www.uptodate.com/index. Accessed May 9, 2012.
- Hernandez-Rodriguez J, et al. Treatment of polymyalgia rheumatica. Archives of Internal Medicine. 2009;169:1839.
- Unwin B, et al. Polymyalgia rheumatica and giant cell arteritis. American Family Physician. 2006;74:1547.
- Glucocorticosteroid-induced osteoporosis. American College of Rheumatology. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gi-osteoporosis.asp. Accessed May 9, 2012.
- Aikawa NE, et al. Anti-TNF therapy for polymyalgia rheumatica: Report of 99 cases and review of the literature. Clinical Rheumatology. 2012;31:575.
- Chang-Miller A (expert opinion). Mayo Clinic, Rochester, Minn. May 15, 2012.
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