Diagnosis

[Mintymow]

Who is best to diagnose PMR/GCA, I don't really feel confdient with my GP's diagnosis too many ifs and buts. Should I ask to see a rheumy. He did put me on Pred and it did help my symptoms but how do I know if it was PMR or just another inflammatary problem, I've had bursitis and a Bakers cyst in my right knee for years plus various aches and pains that come and go and which I've often put down to stress especially over the past three years since my husband had his stroke and I have been his full time carer. Fortunately for me I don't have the symptoms that lots of people describe. I'm not stiff in the mornings with lots of pain. I have had some strange feelings in my scalp which is what my GP based his diagnosis on, PMR not GCA. I was started on 20mg Pred and am now down to 8mg. I have some discomfort in my neck, on a scale of 1 - 10 its about a 2 and very intermitant. On my GP's instruction I am gradually reducing to 5mg and will see him again after a further blood test. ESR was 50to start with, last test was 29. Really quite confused.

[piglette]

Raised ESR and CRP can be an indicator for PMR although it can indicate other things too. Also taking a reasonably low dose of pred say 15-20 mg and having a miraculous improvement within a short time also indicates it probably is PMR. There is no definitive diagnosis, but if you have bilateral pain in the shoulders and/or hips that also could indicate PMR. Your GP should have checked your bloods including RA. I sometimes wonder if I have PMR or something else, but as long as the pred works I suppose I am happy.

[jinasc]

If your GP suspected GCA you should have been referred immediately to Secondary Care level = ie a Consultant.

Take a look at the British Society of Rheumatologists Guidelines on Diagnosis and Treatment of GCA. They can be found on the BSR, NHS, PMR GCA uk site.

[Narducci]

I find it very surprising that your GP has not referred you to a Rheumatologist.

To definitely rule out GCA they would normally do a biopsy before starting you on steroids.

Are you being monitored - ie regular blood tests?

I am not saying that your GP is not equipped to treat you but I really do think that you should ask him for a referral to a Rheumatologist. They are the specialists and best to look after you.

Hope all goes well.