Distinguising features of GCA: Joint pain in jaw, pain in temple area, tenderness across forehead above eye, tenderness of scalp and possible hair loss, ear ache, ringing in ears, neck discomfort (carotid area). Reduced or fluttering pulse in temple.
Requiring immediate specialist attention: flashing lights, double vision, blurring, colour change.
Possible physical disability due to Polymyalgia Rheumatica: aches and disability due to rstriction of movement in both shoulders and/or both hips. If arms are affected, the patient cannot lift their arms above their head.
Possibly raised CRP (and ESR) but this is not a diagnostic test as to the level of inflammation or the danger that vessel damage could occur or contribute to, or increase the risk of having a stroke, heart attack or dementia. Low CRP and ESR might be an indication that vessel damage has already occurred and extra cautions are required.
First line treatment: Presnisolone. Problems associated with this drug - increased risk of infections, delayed wound healing, diabetes, weight gain, fluid retention, muscle wastage, increased blood pressure, irritation of the stomach, bone thinning, mood changes.
Anxiety and depression also associated with these conditions.
Not got so far as stating the blood tests which should be given but DEXA scan once a year is on his list, regular blood pressure of all 4 limbs, testing 5 pulses, diabetes monitoring. Also supplelement are suggested though not got that info either.
