Polymyalgia rheumatica and giant cell arteritis
Full text NHG Guideline on Polymyalgia rheumatica and giant cell arteritis (pdf)
The NHG Guideline Polymyalgia rheumatica and temporal arteritis provides recommendations for diagnosis and treatment of polymyalgia rheumatica (PMR). The guideline also discusses giant cell arteritis (GCA), to the extent that this is associated with PMR.
The objective of this guideline is to help identify patients with PMR and to treat them adequately, considering co-morbidity. The diagnosis is based on a combination of clinical symptoms, elevated ESR and the exclusion of other, possibly serious illnesses. Treatment with glucocorticoids often results in significant improvement in PMR patients.
The guideline helps recognizing signs and symptoms of temporal arteritis and referring the patient in a timely manner. If the patient has (partial or complete) loss of vision, acute decreased visual acuity or double vision, the patient should be referred immediately to an ophthalmologist and evaluated within 24 hours by an internist or rheumatologist.
The guideline program of the College is designed for GPs in the context of the Dutch healthcare system. It makes no warranties concerning the efficacy of the guidelines used in other countries. The information is for educational and/or professional use only and is provided in good faith without any express or implied warranty. The College does not accept responsibility for any loss or damage occasioned by use of the information contained on the website nor from any access to the website. All access and use is at the risk of the end-user.
Hakvoort L, Dubbeld P, Ballieux MJP, Dijkstra RH, Meijman HJ, Weisscher PJ, Willemse BG, Eizenga WH