Skip to main content
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1983 Apr;42(2):168–170. doi: 10.1136/ard.42.2.168

The ESR in the diagnosis and management of the polymyalgia rheumatica/giant cell arteritis syndrome.

M E Ellis, S Ralston
PMCID: PMC1001093  PMID: 6847261

Abstract

A review of 80 patients with the polymyalgia rheumatica/giant cell arteritis (PMR/GCA) syndrome has revealed that the erythrocyte sedimentation rate (ESR) is normal in 22.5% of cases at presentation. Too much reliance on the ESR as a screening test led to delay in diagnosis in 10 patients. Serious complications occurred in 4 patients with a normal or minimally raised ESR. Analysis of follow-up data at 4 weeks showed no significant correlation between change in the ESR and change in symptoms, and at subsequent clinical attendances symptoms did not consistently parallel the ESR. Our results cast serious doubts on the use of the ESR as an entirely reliable diagnostic and therapeutic aid in the PMR/GCA syndrome.

Full text

PDF
168

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bruk M. I. Articular and vascular manifestations of polymyalgia rheumatica. Ann Rheum Dis. 1967 Mar;26(2):103–116. doi: 10.1136/ard.26.2.103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Böttiger L. E., Svedberg C. A. Normal erythrocyte sedimentation rate and age. Br Med J. 1967 Apr 8;2(5544):85–87. doi: 10.1136/bmj.2.5544.85. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Fauchald P., Rygvold O., Oystese B. Temporal arteritis and polymyalgia rheumatica. Clinical and biopsy findings. Ann Intern Med. 1972 Dec;77(6):845–852. doi: 10.7326/0003-4819-77-6-845. [DOI] [PubMed] [Google Scholar]
  4. Graham E., Holland A., Avery A., Russell R. W. Prognosis in giant-cell arteritis. Br Med J (Clin Res Ed) 1981 Jan 24;282(6260):269–271. doi: 10.1136/bmj.282.6260.269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hamilton C. R., Jr, Shelley W. M., Tumulty P. A. Giant cell arteritis: including temporal arteritis and polymyalgia rheumatica. Medicine (Baltimore) 1971 Jan;50(1):1–27. [PubMed] [Google Scholar]
  6. Healey L. A., Parker F., Wilske K. R. Polymyalgia rheumatica and giant cell arteritis. Arthritis Rheum. 1971 Jan-Feb;14(1):138–141. doi: 10.1002/art.1780140120. [DOI] [PubMed] [Google Scholar]
  7. Huston K. A., Hunder G. G. Giant cell (cranial) arteritis: a clinical review. Am Heart J. 1980 Jul;100(1):99–105. doi: 10.1016/0002-8703(80)90285-9. [DOI] [PubMed] [Google Scholar]
  8. Huston K. A., Hunder G. G., Lie J. T., Kennedy R. H., Elveback L. R. Temporal arteritis: a 25-year epidemiologic, clinical, and pathologic study. Ann Intern Med. 1978 Feb;88(2):162–167. doi: 10.7326/0003-4819-88-2-162. [DOI] [PubMed] [Google Scholar]
  9. Jones J. G., Hazleman B. L. Prognosis and management of polymyalgia rheumatica. Ann Rheum Dis. 1981 Feb;40(1):1–5. doi: 10.1136/ard.40.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kogstad O. A. Polymyalgia rheumatica and its relation to arteritis temporalis. Acta Med Scand. 1965 Nov;178(5):591–598. [PubMed] [Google Scholar]
  11. LILJESTRAND A., OLHAGEN B. I. Persistently high erythrocyte sedimentation rate; diagnostic and prognostic aspects. Acta Med Scand. 1955;151(6):425–439. doi: 10.1111/j.0954-6820.1955.tb10311.x. [DOI] [PubMed] [Google Scholar]
  12. Wadman B., Werner I. Therapeutic hazards of phenylbutazone and oxyphenbutazone in polymyalgia rheumatica. Lancet. 1967 Mar 18;1(7490):597–598. doi: 10.1016/s0140-6736(67)90444-8. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES