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JAMA Insights
Clinical Update
August 19, 2020

Polymyalgia Rheumatica and Giant Cell Arteritis

Author Affiliations
  • 1Charité University Medicine, Department of Rheumatology and Clinical Immunology, Berlin, Germany
  • 2Mayo Clinic College of Medicine and Science, Division of Rheumatology, Rochester, Minnesota
  • 3Medical University Graz, Department of Rheumatology and Immunology, Graz, Austria
  • 4Hospital of Brunico (SABES-ASDAA), Department of Rheumatology, Brunico, Italy
JAMA. 2020;324(10):993-994. doi:10.1001/jama.2020.10155

Polymyalgia rheumatica (PMR) should be included in the differential diagnosis of patients with acute onset of bilateral upper extremity pain, which is often worse with or following rest.1 Giant cell arteritis (GCA) is characterized by headache and sometimes acute vision loss. PMR and GCA almost exclusively affect persons aged at least 50 years and frequently have overlapping symptoms, such as fever, fatigue, weight loss, depression, and night sweats, and elevations of inflammatory markers, such as erythrocyte sedimentation rate and C-reactive protein. Based on data from 2015, the overall age- and sex-adjusted prevalence rate in the US of PMR was estimated at 701 per 100 000 population aged at least 50 years and of GCA was estimated at 204 per 100 000 population aged at least 50 years.2 This JAMA Insights article provides an update for a previous review and a suggested algorithm for the diagnosis and management of PMR and CGA.1

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