Temporal arteritis and polymyalgia rheumatica. Clinical and biopsy findings.

Abstract

The clinical, laboratory, and histological findings in 94 patients with temporal arteritis or polymyalgia rheumatica are reported. In 61 patients biopsy specimens from the temporal artery showed arteritis; the other group of 33 patients had clinical polymyalgia rheumatica and a negative biopsy. The frequency of systemic signs was the same in both groups, and the age and sex distribution were the same. Out of 49 patients with myalgia without local findings in the temporal region 20 exhibited arteritis at biopsy. It is difficult to maintain a practical clinical distinction between the two conditions by clinical or histological criteria. The relapse rate was 26% among patients with arteritis and 18% among biopsy-negative patients; it is therefore recommended to continue corticosteroid therapy for a minimum of 2 years. By repeat biopsies during and after the treatment it was shown that histological changes in the temporal artery may persist for a long time.