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Should all patients with polymyalgia rheumatica have a vascular ultrasound assessment?
  1. Sharon Cowley1,2,
  2. Patricia Harkins2,3,
  3. Colm Kirby1,
  4. Richard Conway3,
  5. David J Kane1,2
  1. 1Department of Rheumatology, Tallaght University Hospital, Dublin, Ireland
  2. 2Trinity College Dublin, Dublin, Ireland
  3. 3Department of Rheumatology, St James Hospital, Dublin, Ireland
  1. Correspondence to Dr Sharon Cowley, Department of Rheumatology, Tallaght University Hospital, Dublin, Ireland; sharoncowley111{at}gmail.com

Abstract

There is a growing appreciation that both giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are closely interrelated conditions that have significant overlap in aetiology, clinical characteristics and treatment regimens. Subclinical GCA in PMR is becoming increasingly recognised, and there is evolving evidence that this may be a more aggressive disease phenotype than PMR. Ultrasound (US) lends itself well as a screening tool for GCA in PMR; it is inexpensive, non-invasive, widely available, lacks ionising radiation, may be performed at the bedside and is recommended by EULAR as a first-line investigation for suspected GCA. There is insufficient evidence to currently recommend that all patients with PMR should have a US assessment for vascular involvement. However, as clinical and laboratory parameters alone do not accurately diagnose patients with subclinical GCA, we suggest that vascular US will be increasingly performed by rheumatologists in practice to identify these patients with PMR, preferably as part of larger prospective outcome studies.

  • Polymyalgia Rheumatica
  • Giant Cell Arteritis
  • Ultrasonography
  • Vasculitis

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Footnotes

  • Handling editor Josef S Smolen

  • Contributors SC is the main author of the article, writing the first draft and making corrections based on co-author feedback. PH, CK, RC and DJK were involved in drafting the manuscript and approving the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests SC: grant support from Novatris, speaker honoria from Janssen and conference attendance support from Abbvie, Janssen and Novartis. CK: conference attendance support from Novartis. PH: grant support from Janssen and Novartis and conference attendance support from Abbvie and Novartis. RC: grant support from Janssen and Novartis and consulting fees/speaker fees from Janssen, Abbvie, Fresenius Kabi, Galapagos, UCB, Viatris, Celltrion, Nordic Pharma and Novartis. DJK: grant support from Novartis and conference attendance support from Abbvie.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.