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Symptoms
Symptoms of PMR often develop within two weeks. They may include:
- Muscle pain and/or stiffness in the hip, shoulder, or neck areas
- Stiffness in the morning
- Fever
- Unexplained weight loss
- Anemia
- Fatigue
- Mood changes
Symptoms of GCA may include:
- All PMR symptoms
- Headache, sometimes very severe, may also be associated with scalp hypersensitivity to touch
- Pain or tenderness in the temple
- Changes in vision
- Pain in the jaw or tongue with chewing
GCA needs to be treated immediately. This condition can lead to permanent blindness.
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. There is no single test for PMR. To support the diagnosis and rule out other conditions, tests may include:
- Erythrocyte sedimentation rate (ESR)—a blood test that measures how quickly red blood cells fall to the bottom of a test tube. In the case of inflammation, levels of fibrinogen increase in the blood. Fibrinogen makes the red blood cells clump. This makes them fall faster.
- Rheumatoid factor (RF)—a blood test that looks for a specific antibody (RF) in the blood. A positive RF test suggests a condition other than PMR.
- Complete blood count—a blood test that measures the amount of different blood cells present in whole blood. Patients with GCA or PMR often have anemia. This will result in low counts of red blood cells. Patients with PMR have elevated levels of platelets.
- C-reactive protein—a protein produced in the liver. It increases when there is inflammation.
- Muscle biopsy —removal of a sample of muscle tissue for examination (rare).
If you have PMR, your doctor may also consider the possibility of GCA. Evaluation for GCA includes:
- Physical exam, including vision test
- Biopsy of an affected blood vessel is necessary to confirm the diagnosis