Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • shoulder/hip girdle stiffness
  • shoulder/hip girdle pain
  • rapid response to corticosteroids

Other diagnostic factors

  • acute onset
  • low-grade fever
  • anorexia
  • weight loss
  • malaise
  • depression
  • asthenia
  • oligoarticular arthritis

Risk factors

  • over 50 years
  • giant cell arteritis (GCA)
  • female gender

Diagnostic investigations

1st investigations to order

  • ESR
  • C-reactive protein (CRP)
  • CBC
  • ultrasound
Full details

Investigations to consider

  • TSH
  • MRI
  • serum protein electrophoresis
  • serum creatine phosphokinase
Full details

Emerging tests

  • interleukin (IL)-6
  • fluorodeoxyglucose F-18 PET scan
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Chief of Rheumatology

VA Greater Los Angeles Healthcare System

Associate Clinical Professor of Medicine

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

AW declares that he has no competing interests.

Dr Ari Weinreb would like to gratefully acknowledge Dr Lynell Newmarch, a previous contributor to this monograph. LN declares that she has no competing interests.

Peer reviewers VIEW ALL

Vice Chairman of Medicine for Education

Professor of Medicine

Cleveland Clinic Lerner College of Medicine

Case Western Reserve University

Editor in Chief

Cleveland Clinic Journal of Medicine

Cleveland Clinic

Cleveland

OH

Disclosures

BFM declares that he has no competing interests.

Consultant Rheumatologist

BHRT University Hospital

Queen’s Hospital

Romford

UK

Disclosures

KC declares that he has no competing interests.

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