Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology.

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Giant Cell Arteritis and Polymyalgia Rheumatica Definition

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Teaching NeuroImages Neurology Resident and Fellow Section © 2013 American Academy of Neurology

Vignette A 62-year-old woman presented with four months of neck, shoulder, and hip pain, morning stiffness, and elevated inflammatory markers, leading to the diagnosis of polymyalgia rheumatica (PMR). Right-sided headache Right superficial temporal artery biopsy showed giant cell arteritis. The patient was treated with prednisone. Ginat et al.

Imaging Ginat et al. 12 3

Polymyalgia rheumatica and giant cell arteritis Polymyalgia rheumatica is an inflammatory condition that can manifest with interspinous bursitis. 1 Giant cell arteritis is a granulomatous vasculitis that affects medium and large vessels and occurs in 16 to 21% of patients with PMR. 2 MRA can show narrowing of the affected artery and contrast-enhanced MRI can reveal surrounding inflammatory changes. Color Doppler ultrasound can show arterial wall edema (“halo sign”), which can persist during steroid therapy. 3 Ginat et al.