Podcasts about polymyalgia

Dr. Martin answers questions sent in by our listeners. Some of today's topics include: Bypass surgery & multi nutrient supplement Polymyalgia rheumatica Gluteal tendinopathy Itchy eyebrows Constipation on the Reset Exercise for arthritis Cold water to boost metabolism Accutane for acne Eating for your blood type Taking calcium with vitamin D and zinc  

In this episode, we review the high-yield topic ⁠⁠⁠⁠Polymyalgia Rheumatica⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠from the Rheumatology section at ⁠⁠⁠⁠⁠⁠Medbullets.com⁠⁠⁠⁠⁠⁠ Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets Linkedin: https://www.linkedin.com/company/medbullets

Board certified rheumatologist – Dr. Robert Goodman talks about risk factors, diagnosis, and treatment options for polymyalgia rheumatica.

Dr. Janet Pope discusses abstracts LBA0001, OP0233, OP0261 and POS0280 at Eular 2024 in Vienna, Austria.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: William F.C. Rigby, MD Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition that can be difficult to diagnose and treat. For instance, PMR is a diagnosis of exclusion, and it can mimic a wide variety of other conditions. And once a patient is accurately diagnosed, the standard-of-care treatment with glucocorticoids may result in toxicity for some patients. Learn more about these and other diagnostic and treatment challenges as well as other treatment options with Dr. Charles Turck and Dr. William Rigby, Professor of Medicine and of Microbiology and Immunology at the Geisel School of Medicine at Dartmouth. © 2024 Sanofi and Regeneron Pharmaceuticals, Inc. All rights reserved.MAT-US-2403256 v1.0 - P Expiration Date 04/16/2025

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: William F.C. Rigby, MD Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition that can be difficult to diagnose and treat. For instance, PMR is a diagnosis of exclusion, and it can mimic a wide variety of other conditions. And once a patient is accurately diagnosed, the standard-of-care treatment with glucocorticoids may result in toxicity for some patients. Learn more about these and other diagnostic and treatment challenges as well as other treatment options with Dr. Charles Turck and Dr. William Rigby, Professor of Medicine and of Microbiology and Immunology at the Geisel School of Medicine at Dartmouth. © 2024 Sanofi and Regeneron Pharmaceuticals, Inc. All rights reserved.MAT-US-2403256 v1.0 - P Expiration Date 04/16/2025

Host: Darryl S. Chutka. M.D.; [@chutkaMD] Guest: Cornelia M. Weyand, M.D., Ph.D. Guest: Kenneth J. Warrington, M.D. Rheumatologic problems are some of the most common health conditions we see as primary care professionals. In many cases, taking months and sometimes years to properly diagnose, rheumatologic conditions can become frustrating for both the provider and the patient. There are a variety of new tests available to help us establish a diagnosis, as well as multiple new and effective treatment options. This episode is part of a seven-episode mini-series on Mayo Clinic Talks dedicated to rheumatologic health problems to aid in the recognition, diagnosis, and treatment for your patients. Please find these episodes where you listen to podcasts or on ce.mayo.edu. Polymyalgia rheumatica was first described in 1966 as a case report. It can have a wide range of symptoms and at times, can be challenging to diagnose. As with most rheumatologic disorders, the exact cause isn't known. While there are no specific laboratory tests which establish a diagnosis, there are some that are very useful. One of the most important features of polymyalgia is its relationship with vasculitis and temporal arteritis. In this podcast, we'll discuss polymyalgia rheumatica with rheumatologists Cornelia M. Weyand, M.D., Ph.D., and Kenneth J. Warrington, M.D., from the Mayo Clinic. We'll review the typical presenting symptoms, how to establish a diagnosis, helpful laboratory tests and its management. Connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. Learn more about our Rheumatology Edition here: https://ce.mayo.edu/content/mayo-clinic-talks-rheumatology-edition 

Starke Schmerzen in Schulter oder Nacken, Steifigkeit der Gelenke, Krankheitsgefühl – die Polymyalgia rheumatica (PMR) präsentiert sich meist eindrucksvoll, ist aber heilbar. Im Gegensatz dazu ist die mit der PMR vergesellschaftete Riesenzellarteriitis ein Notfall. Wie Sie in der Praxis beide Krankheitsbilder von einander unterscheiden und was Sie zur Therapie wissen müssen, erklärt der Rheumatologe und Hausarzt Dr. med. Ron Philipps.

Join us in this week's episode as Rheumatology Registrar, Dr Mohita Damany, gives us a quick run down of PMR. 

About a year ago Linda Rinaldi began to feel full body pain. It felt like she had exercised too much, but when it became more extreme, she knew something was wrong. In a matter of days, she was diagnosed with polymyalgia rheumatica (PMR), a condition she had never heard of. Linda joins this episode of The Health Advocates to share her PMR patient journey and how the diagnosis ultimately led her to becoming a health advocate through sharing her story. Linda encourages others to listen to their body and speak up: “My advice is: don't stop. Tell the doctor; tell as many doctors as will listen to you what your symptoms are and advocate for yourself. You have to because if you don't, nobody else will do it. And nobody knows your body, what you're feeling, and what you're going through better than you.” This episode was made possible with support from Sanofi. Among the highlights in this episode: 01:07: Linda describes the onset of her PMR symptoms, likening them to feeling overexerted due to intense exercise 02:16: Linda details her initial struggle with PMR, emphasizing the severity of her symptoms that affected her entire body 03:34: Zoe Rothblatt, Associate Director of Community Outreach at GHLF, inquires about Linda's experience upon visiting a rheumatologist for the first time 05:00: Zoe relates to Linda's experiences living with a chronic condition and notes the importance of having a reliable care team 06:47: Linda explains the nature of her PMR symptoms in detail, emphasizing her rapid improvement after starting steroid treatment 12:18: Zoe and Linda discuss the importance of sharing their health stories to help others 13:27: Linda advises listeners to be proactive in addressing symptoms, highlighting the importance of self-advocacy in health care Contact Our Hosts Steven Newmark, Director of Policy at GHLF: snewmark@ghlf.org Zoe Rothblatt, Associate Director, Community Outreach at GHLF: zrothblatt@ghlf.org A podcast episode produced by Ben Blanc, Manager of Programs & Special Projects at GHLF. We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to podcasts@ghlf.org Catch up on all our episodes on our website or on your favorite podcast channel.See omnystudio.com/listener for privacy information.

The Health Advocates are joined by rheumatologist Dr. Grace Wright to learn about polymylagia rheumatica (PMR). Dr. Wright shares about the diagnosis process of PMR and how we must do better on shortening the time to diagnosis and getting patients treated.  She also discusses common symptoms and telltale signs of PMR interfering in everyday life. “I think the most important thing always in rheumatology is to remember the [patient] story is the most critical,” says Dr. Grace Wright. This episode was made possible with support from Sanofi. Among the highlights in this episode: 01:02: Dr. Wright outlines her background in rheumatology, and her involvement with the Association of Women in Rheumatology, emphasizing the importance of education and equity in managing rheumatic diseases 01:42: Dr. Wright describes PMR's symptoms, particularly affecting shoulders and hips, and clarifies that while PMR can be effectively managed, it is not necessarily curable 03:25: Dr. Wright elaborates on the typical progression from initial symptoms to diagnosis, highlighting the importance of blood tests in identifying PMR 04:44: Dr. Wright discusses the challenges in the diagnosis and treatment of PMR, stressing the often lengthy delay before patients receive appropriate care from a rheumatologist 05:45: Steven Newmark, Director of Policy at GHLF and Dr. Wright discuss the prevalence of PMR compared to other arthritis types 07:07: Dr. Wright offers advice for patients seeking help for PMR and emphasizes the importance of being attentive to changes in patient's daily functioning and the need for timely consultation with a rheumatologist 09:26: Dr. Wright discusses resources available for patients coping with PMR and the importance of equity in health care 11:55: What our hosts learned from this episode Contact Our Hosts Steven Newmark, Director of Policy at GHLF: snewmark@ghlf.org Zoe Rothblatt, Associate Director, Community Outreach at GHLF: zrothblatt@ghlf.org We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to podcasts@ghlf.org Catch up on all our episodes on our website or on your favorite podcast channel.See omnystudio.com/listener for privacy information.

Polymyalgia rheumatica is a common rheumatic disorder. Steroids are the mainstay of therapy despite significant adverse reactions. Join host, Geoff Wall, as he evaluates a new treatment for PMR.The GameChangerSarilumab is now FDA-approved for relapsing polymyalgia rheumatica. Sarilumab can be an alternative to long-term steroid therapy or methotrexate. HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint Health ReferenceSpiera RF, Unizony S, Warrington KJ, Sloane J, Giannelou A, Nivens MC, Akinlade B, Wong W, Bhore R, Lin Y, Buttgereit F, Devauchelle-Pensec V, Rubbert-Roth A, Yancopoulos GD, Marrache F, Patel N, Dasgupta B; SAPHYR Investigators. Sarilumab for Relapse of Polymyalgia Rheumatica during Glucocorticoid Taper. N Engl J Med. 2023 Oct 5;389(14):1263-1272. doi: 10.1056/NEJMoa2303452. PMID: 37792612.https://www.nejm.org/doi/full/10.1056/NEJMoa2303452 Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Describe the diagnosis and treatment of polymyalgia rheumatica 2. Assess the SAPHYR study and the role of sarilumab for treatment of polymyalgia rheumatica 0.05 CEU/0.5 HrUAN: 0107-0000-23-352-H01-P Initial release date: 11/6/2023Expiration date: 11/6/2024Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagramDownload the CEimpact App for Free Continuing Education + so much more!

This episode covers polymyalgia rheumatica.Written notes can be found at https://zerotofinals.com/medicine/rheumatology/pmr/ or in the rheumatology section of the 2nd edition of the Zero to Finals medicine book.The audio in the episode was expertly edited by Harry Watchman.

In this episode, I spoke with John Graham, who's personal journey through training and competitions exposed him to injuries, fueling his quest for optimized injury prevention and recovery methods. During this pursuit, John discovered the remarkable benefits of red light therapy whilst recovering from a knee injury. This led to the creation of a red light therapy product, providing convenient and efficient red light therapy treatment for individuals, and athletes to aid recovery and reduce pain.Red light therapy was something I had heard a lot about, but hadn't dug much into the research behind it, so I was really looking forward to learning all about the benefits of red light therapy, especially with regards to pain reduction. We discussed:2:38John's Journey14:00What Is Red Light?25:20Red Light Therapy for exercise recovery and injury prevention40:20Red Light Therapy for Pain reduction46:30Red Light Therapy for Skin conditions 50:20Red Light Therapy for Fibromyalgia, Polymyalgia and Psoriatic Arthritis53:32Red Light Therapy and Lumbar Disc InjuriesYou can find John @:https://www.lumaflex.com/https://www.instagram.com/lumaflex/https://www.facebook.com/lumaflexbodypro/https://www.youtube.com/@lumaflexhttps://twitter.com/LumaflexBodyProSupport the showDon't forget to leave a Rating for the podcast!You can find Leigh @:Leigh website - https://www.bodychek.co.uk/Leigh's books - https://www.bodychek.co.uk/books/ Eliminate Adult Acne Programme - https://skinwebinar.com/HEAL THEM Education Programme - http://healthemeducation.vhx.tv/ Radical Health Rebel YouTube Channel - https://www.youtube.com/@radicalhealthrebelpodcast

In deze aflevering van Gewrichtige Gesprekken gaan we het hebben over een aandoening die tot nu toe op relatief weinig wetenschappelijke belangstelling kon rekenen: polymyalgia rheumatica. Maar tijden veranderen en gelukkig kan Aatke van der Maas (reumatoloog, Sint Maartenskliniek) ons bijpraten over de laatste inzichten. Is er voor PMR dan toch meer mogelijk dat alleen prednison? Muziek komt ook in deze aflevering weer voorbij 

Polymyalgia Rheumatica treatments often involve high-dose steroids for long periods. Lisa shares the details of her journey with the all-natural approach of the Paddison Program with outstanding success. For the transcription and for more helpful information visit http://www.rheumatoidsolutions.com

Jack March aka the rheumatology physio returns to talking about PMR and the treatment route He explains what the symptoms are and how its diagnosed and discusses the treatment pathway along with measures that can be taken to improve the symptoms KEY TAKEAWAYS PMR occurs 3x more in women than it does in men and a typical onset is a pain and stiffness in the shoulders when you wake up in the morning There is an overlap of rheumatology conditions which can make diagnosis challenging There is a risk of it developing into rheumatoid arthritis and the difficulties that brings High levels of inflammation can cause problems with your cardiovascular system It is almost exclusively treated with steroids and the results are seen very quickly Steroids can affect bone density, muscle bulk and your lymphatic system Measures to protect bone density need to be put in place and loading can be an effective approach BEST MOMENTS ‘It's about understanding the individual in front of you' ‘People need to understand what they are doing and why they are doing it' ‘A healthy diet, and exercise can help improve the symptoms' RESOURCES FOR THIS EPISODE www.rheumatology.physio THE BACK PAIN PODCAST PROVIDER MAP - FINDING SOMEONE TO HELP YOU WITH YOUR BACK PAIN https://thebackpainpodcast.com/index.php/members-map/ VALUABLE RESOURCES The Back Pain Podcast The Back Pain Podcast website The Back Pain Podcast recommended products affiliate link Our Rode Mixer https://amzn.to/3waU8bx Our Microphones https://amzn.to/3rzSZ9Z Second Microphone https://amzn.to/2ObKMeA XLR Cable https://amzn.to/3rBL8ZB Studio Headphones https://amzn.to/3u082LE Laptophttps://amzn.to/3dhfafT Our webcam https://amzn.to/31uUefQ  ABOUT THE HOSTS Dave Elliott Dave is the owner of Advanced Chiropractic, a chain of Chiropractic and massage therapy clinics in Essex, UK. Dave still sees patients during the week but has been working hard to talk to as many experts in the field of back pain as possible to help distil all the information and bring it to you in this awesome podcast. You can find Dave on any of the Advanced Chiropractic social media platforms, or you can contact him at hello@thebackpainpodcast.com   if you have any questions for him. -Instagram  Rob Beaven Rob owns and runs a multidisciplinary clinic, The Dyer St Clinic in Cirencester Gloucestershire. His team of Chiropractors, Physiotherapists, Osteopaths, Doctors, and podiatrists all collaborate on thousands of back pain patients every year. Alongside Dave, he has worked hard to bring to the table experts across all industries to give you the low down on back pain, with steps you can implement today to start feeling better. -Instagram -Twitter SOCIAL MEDIA LINKS Instagram Twitter FacebookSupport the show: https://thebackpainpodcast.comSee omnystudio.com/listener for privacy information.

Long-term use of glucocorticoids for polymyalgia rheumatica: follow-up of the PMR Cohort study  Dr Sara Muller (Keele University, UK) and Prof Samantha Hider (Keele University, UK) join Dr Sheilla Achieng to discuss a follow-up to the PMR cohort study, an inception cohort of 652 patients from English general practices who were diagnosed with PMR between 2012 and 2014. They identify the main findings from the follow-up and highlight that PMR is not always a time-limited condition. Read the full paper: Long-term use of glucocorticoids for polymyalgia rheumatica: follow-up of the PMR Cohort Study Want to find out more about polymyalgia rheumatica? Listen to this episode of our sister podcast, Talking Rheumatology Spotlight. Keywords: polymyalgia rheumatica, PMR, vasculitis, steroids, glucocorticoids, corticosteroids, prednisone, prednisolone, rheumatology.Thanks for listening to Talking Rheumatology Research! Join the conversation on Twitter using #TalkingRheumResearch, tweet us @RheumJnl, or find us on Instagram. Want to read more rheumatology research? Explore Rheumatology and Rheumatology Advances in Practice.

Dr. Ebell and Dr. Wilkes discuss the POEM titled ' Tocilizumab beneficial for adults with persistent polymyalgia rheumatica symptoms who receive steroid therapy '

In this episode, we review the high-yield topic of Polymyalgia Rheumatica from the MSK section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

Board Certified Rheumatologist, Dr. Robert Goodman of the Arthritis and Rheumatology Clinic discusses a condition that can occur outside of the joints, called Polymyalgia Rheumatica. This condition can lead to what is called Giant Cell Arteritis if left untreated.

Dr. David Deardon 13th Oct 2022 – Polymyalgia rheumatica and giant cells arteritis...with TRE's Selina MacKenzie

Polymyalgia Rheumatica and Giant Cell Arteritis (Episode 82, To Your Health with Dr. Jim Morrow) On this episode, host Dr. Jim Morrow describes two related little-known conditions called Polymyalgia rheumatica and Giant cell arteritis, also known as Temporal arteritis. These conditions involve inflammation of the arteries and usually occur in the elderly and affect mostly […] The post Polymyalgia Rheumatica and Giant Cell Arteritis appeared first on Business RadioX ®.

Polymyalgia Rheumatica and Giant Cell Arteritis (Episode 82, To Your Health with Dr. Jim Morrow) On this episode, host Dr. Jim Morrow describes two related little-known conditions called Polymyalgia rheumatica and Giant cell arteritis, also known as Temporal arteritis. These conditions involve inflammation of the arteries and usually occur in the elderly and affect mostly […]

Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief of JAMA, the Journal of the American Medical Association, for the September 20, 2022, issue.

Hosted by Dr Mariam Malik, this months spotlight podcast covers Polymyalgia rheumatica. Through her chat with Dr Sarah Mackie and Dr Max Yates they explore an overview of PMR, response to treatment, compications of disease and steorid related adverse events. 

In this episode, we review the high-yield topic of Polymyalgia Rheumatica from the Rheumatology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbullets

Dr. Martin answers questions sent in by our listeners. Some of today's topics include: Vitamin K2 in meat and butter Serum calcium NAC (N-acetyl cysteine) Curcumin & kidney stones Liposomal C supplement Almond flour  Digestion time for meat Ketone powder Arterial plaque Polymyalgia rheumatica  

A client is tapering off her prednisone to treat her polymyalgia rheumatica. She still has persistent pain in her shoulders. Is there anything her massage therapist can safely do to help her? Polymyalgia rheumatica sounds dire. The good news is, it's highly treatable, and massage—with respect for pain and medications—is a great choice for people who are recovering.   Sponsors:     Anatomy Trains: www.anatomytrains.com      Books of Discovery: www.booksofdiscovery.com       Host Bio:                    Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.                                     Recent Articles by Ruth:          “Chemotherapy-Induced Peripheral Neuropathy and Massage Therapy,” Massage & Bodywork magazine, September/October 2021, page 33, http://www.massageandbodyworkdigital.com/i/1402696-september-october-2021/34.           “Pharmacology Basics for Massage Therapists,” Massage & Bodywork magazine, July/August 2021, page 32, www.massageandbodyworkdigital.com/i/1384577-july-august-2021/34.          “Critical Thinking,” Massage & Bodywork magazine, May/June 2021, page 54, www.massageandbodyworkdigital.com/i/1358392-may-june-2021/56.         Resources:     Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app   Nancy Garrick, D.D. (2017) Polymyalgia Rheumatica, National Institute of Arthritis and Musculoskeletal and Skin Diseases. Available at: https://www.niams.nih.gov/health-topics/polymyalgia-rheumatica   ‘Polymyalgia Rheumatica' (no date) NORD (National Organization for Rare Disorders). Available at: https://rarediseases.org/rare-diseases/polymyalgia-rheumatica/ (Accessed: 16 November 2021).   ‘Polymyalgia Rheumatica: Practice Essentials, Pathophysiology, Etiology' (2021). Available at: https://emedicine.medscape.com/article/330815-overview#a7 (Accessed: 16 November 2021).   About our sponsors:   Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.      Website: anatomytrains.com       Email: info@anatomytrains.com          Facebook: facebook.com/AnatomyTrains     Instagram: instagram.com/anatomytrainsofficial        YouTube: www.youtube.com/channel/UC2g6TOEFrX4b-CigknssKHA  

It's not as self-limiting as generally thought and is often misdiagnosed for months.

Giant Cell Arteritis and Polymyalgia Rheumatic Wrapup: Drs. Calabrese, Liew, Conway and Mackie

Giant Cell Arteritis and Polymyalgia Rheumatic Wrapup: Drs. Calabrese, Liew, Conway and Mackie

Dr. Martin answers questions sent in by our listeners. Some of today's topics include: White bumps on the skin Acupuncture Colonoscopies and your microbiome Polymyalgia rheumatica Palmitoylethanolamide (PEA) Skin tags and insulin resistance Plantar fasciitis Caffeine pills Fish or omega-3 capsules? Tilia tomentosa Tune in to hear Dr. Martin's responses!  

In this episode we discuss the approach to diagnosis and management of GCA and Polymyalgia Rheumatica. Written by: Dr. Haonan Mi (Internal Medicine Resident) Reviewed by: Dr. Tanveer Towheed (Rheumatology) and Dr Zijing Wu (General Internal Medicine)

Episode 33 NPTEFF Podcast Content Polymyalgia Rheumatica

Episode 34 NPTEFF Podcast Question Polymyalgia Rheumatica

Video bei YouTube: Medizinmensch Rheuma! Ein Rheumatologe gibt Tipps - So erkennst Du RHEUMA! Rheumatische Erkrankungen bezeichnen entzündliche Prozesse: Rheumatoide Arthritis, Rheumatisches Fieber, sowie Polymyalgia Rheumatica gehören dazu. Auch Kinder und Jugendliche können an Rheuma leiden! Unter anderem lernst du den Unterscheid zwischen (Rheumatisches Fieber, Rheumatoide Arthritis, Polymyalgia Rheumatica — PMR) Meine Website: https://medizinmensch.de Kaffee spenden: https://buymeacoffee.com/Medizinmensch Time Stamps: 0:00 Intro 0:20 Rheuma = Sammelbegriff für unterschiedliche entzündliche Erkrankungen 0:30 Anzeichen von Entzündung 2:01 Daran spürst Du Entzündung (Aufbau von Gelenken) 4:23 Typische Muster von Rheuma 4:37 Rheumatoide Arthritis 6:09 Rheumatisches Fieber 7:13 Polymyalgia Rheumatica 8:03 Rheuma im weiteren Sinne 8:17 Schwere Gicht mit Gichtknoten 9:03 Kein Rheuma — Arthrose 9:48 weitere "rheumatische" Erkrankungen (SLE, Vaskulitis, Sklerodermie) 10:15 Fehlfunktion des Immunsystem als Ursache von Rheuma 12:22 Rheumatische Erkrankungen mit Störungen des angeborenen Immunsystems 12:30 Zyklysche Fiebersyndrome (Familiäres Mediterranes Fieber) 13:34 Rheuma erkennen, Muster erkennen Glossar: Arthrose: Eine degenerative Gelenkerkrankung, die u.a. zu Verlust des Gelenkknorpels und Gelenkschmerzen führen kann. Bei Arthrose handelt es sich um keine Rheuma-Erkrankung. Polymyalgia Rheumatica (PMR): Eine rheumatische Krankheit, die vorallem durch Schmerzen und Steifigkeit in Hüft- und Schulterberecih geprägt ist Rheumatoide Arthritis: Eine entzündliche Erkrankung unter anderem der Gelenke (vorallem sind kleine Gelenke, typischerweise in symmetrischem Muster betroffen). Bei Rheumatoider Arthritis sind oft auch Blutgefäße, Lymphknoten, Milz und andere Organe von Entzündung betroffen Rheumatisches Fieber: Das sogenannte rheumatische Fieber entsteht nach einer Infektion mit Streptokokken (Bakterien); oftmals innerhalb von 1-5 Wochen nach der Infektion. Heute ist Rheumatisches Fieber, u.a. durch die Verbreitung von Antibiotika in der westlichen Welt selten geworden. Rheumatologe: Ein Facharzt für die Diagnose und Behandlung rheumatischer Erkrankungen Weitere Videos von mir (Playlists): Autoimmunerkrankungen: https://bit.ly/MM-Autoimmunerkrankungen Blutwerte erklärt: https://bit.ly/MM-Blutwerte Coronavirus & Covid-19: https://bit.ly/MM-Corona Gicht & Pseudogicht: https://bit.ly/MM-Gicht Medizin leicht erklärt: https://bit.ly/MM-Medizin-erklaert Merk-würdiges Medizinwissen für Alle. Abonniere jetzt und erhalte neue Folgen, jeden Medizin-Mittwoch. Folge direkt herunterladen

I can't tell you how excited I am about this podcast! Professor Dasgupta is AMAZING, he has led the line on writing PMR guidelines, developing fast track clinics, teaching Rheumatology and just generally being an awesome guy. We delve deep into PMR from a primary care perspective, he gives excellent detail on recognition, management, investigation, differential diagnoisis, diagnostic uncertainty and wow, this might take a couple of listens! Find the Professor on twitter here he runs webinars that are invaluable and packed full of information, details are on his feed, I will see you at them! Please subscribe to the channel and if you are on iTunes, leave a review (5 stars ought to do it)! See you next time!

Dr. Centor discusses polymyalgia rheumatica and giant cell arteritis with Dr. Sebastian E. Sattui Cortes.

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This episode covers polymyalgia rheumatica!

Welcome back to our weekend Cabral HouseCall shows! This is where we answer our community's wellness, weight loss, and anti-aging questions to help people get back on track! Check out today's questions:  Michael: Hello Dr. Cabral, why does my dermatitis get worse when I eat dairy, gluten or grains? If I do consume those foods I also get dandruff, joint pain, muscle aches, anxiety and brain fog? What should I do to resolve this? Thank you. Michael: Hello Dr. Cabral, what would be the cause of b vitamins causing me to get shortness of breath and anxiety? Luke: Hi, Dr. Cabral!I'm writing on behalf of my mom. She's 65 years old, 115 lbs, 5'1. She was diagnosed with Polymyalgia Rhumatica (PMR) about 9 years ago after a few very stressful incidents, (and a very high-stress life in general). She took Prednisone for SIX YEARS, starting on 15mg and eventually tapering down to 2mg. Then she transitioned to low-dose Naltrexone for 2 years, and is now off medication entirely. The severe body pain went away, but her blood pressure is now extremely high, sometimes 180/60. We've been measuring it over the course of several months with little change. She also suffers from a lot of bone loss. We did the 21 day detox, but it's honestly very hard to get her take in enough nutrition. No junk food, but very little nutrition in her diet and almost no exercise. I'd really love to get her blood pressure down and then help her apply the parts of the DESTRESS protocol that she's ready for, but as you know, it's very hard to get family to listen to you when it comes to their health...ESPECIALLY with exercise! What would you recommend? Michael: Hello Dr Cabral, I was taking a probiotic supplement of 100 billion bfu. Within days I started To feel itchy skin, dry eyes, constipation nausea, anxiety and many more symptoms. It’s been a week since I stopped taking the supplement and I’m still symptomatic do you know what would be the cause ? Melissa: Hello,I wondering what your thoughts were on energetic testing as a tool for finding root causes? Certainly functional testing reveals a lot, but I've seen several people uncover dis-ease with things like applied kinesiology aka muscle testing, bioresonance scans, Zyto scans, frequency testing etc, that even functional lab work has missed. Can you explain how those work and if they are at odds with functional testing or complementary to it? Thank you! Ron: Hi I am a 59-year-old male I have been chronically ill for 30 years.I have been everywhere tried just about everything. Recently had a swack of tests done by integrated Medicine Dr and I have been diagnosed with leaky gut, Leaky Brain, and Autoimmune issues.I have also been unsuccessful in trying to follow doctor's instructions for the last 8 months mostly on a mold protocol. I recently was trying to purchase Mega spore probiotics and was told By an integrated pharmacist that she would need to see me first . She did not give me the probiotics but wanted to work on some stuff first. On my recent visit when I told her I had to take crazy amounts of Biotin to survive my liver would even ache she replied I think you have a fungal infection. So we are not just talking yeast in the intestinal tract we are talking yeast switching to fungus and penetrating the intestinal wall and spreading through the whole Body. I have heard Dr Cabral talk about fixing the Gut I would be interested in hearing if he knows how to fix this or if he knows someone who could help me. Please get back to me ASAP as I am desperate. If you are looking for a challenge it has arrived.   Thank you for tuning into today's Cabral HouseCall and be sure to check back tomorrow where we answer more of our community’s questions!  - - - Show Notes & Resources: http://StephenCabral.com/1730 - - - Get Your Question Answered: http://StephenCabral.com/askcabral   - - - Dr. Cabral's New Book, The Rain Barrel Effect https://amzn.to/2H0W7Ge - - - Join the Community & Get Your Questions Answered: http://CabralSupportGroup.com - - -  Dr. Cabral’s Most Popular At-Home Lab Tests: > Complete Minerals & Metals Test (Test for mineral imbalances & heavy metal toxicity) - - - > Complete Candida, Metabolic & Vitamins Test (Test for 75 biomarkers including yeast & bacterial gut overgrowth, as well as vitamin levels) - - - > Complete Stress, Mood & Metabolism Test (Discover your complete thyroid, adrenal, hormone, vitamin D & insulin levels) - - - > Complete Stress, Sleep & Hormones Test (Run your adrenal & hormone levels) - - - > Complete Food Sensitivity Test (Find out your hidden food sensitivities) - - - > Complete Omega-3 & Inflammation Test (Discover your levels of inflammation related to your omega-6 to omega-3 levels) - - - > View all Functional Medicine lab tests (View all Functional Medicine lab tests you can do right at home for you and your family!)

Episode 313 of the "Sports Illustrated Media Podcast" features an interview with popular radio host, Dan Patrick. The man known as DP opened up about his battle with Polymyalgia, the ups and down of his longtime career, the art of interview, who the best people are to interview, the one interview he'd like to get, his new podcast, "That Scene with Dan Patrick," leaving ESPN, his relationship with Keith Olbermann and much more. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Laut deutscher Gesellschaft für Schmerzmedizin leiden mehr als 23 Millionen Menschen in Deutschland an chronischem Schmerz. Eine mögliche Ursache: Die entzündliche Schmerzerkrankung Polymyalgia Rheumatica, abgekürzt PMR. Doch was spricht für eine mögliche Erkrankung mit PMR? Wieso entsteht PMR und wie wird PMR behandelt? Was gilt es bei der Therapie vopn PMR zu beachten? I ch bin Christian, FA fuer Innere Medizin und Rheumatologie lade euch ein hier mehr zu erfahren über die entzündliche Schmerzerkrankung Polymyalgia Rheumatica oder PMR. 0:00 Intro 1:09 Anzeichen von PMR 1:43 Anzeichen entzündlicher Schmerz 2:46 Typische Präsentation 4:23 Labortests 6:32 Wie ensteht Polymyalgia Rheumatica PMR 9:33 Zusammenfassung Entstehung 10:03 Arteriitis Temporalis (Riesenzellarteriitis) 11:47 PMR Therapie 12:45 Glucocorticoide 14:02 Prinzip der Therapie 15:20 Fehlendes Ansprechen and Therapie 16:40 Prävention von Nebenwirkungen 17:35 Zusammenfassung 19:15 Outro Links: Deutsche Rheuma Liga: https://dgrh.de/ Deutsche Gesellschaft für Schmerzmedizin: https://www.dgschmerzmedizin.de/ Polymyalgia Rheumatica (PMR) Leitlinien EULAR/ACR (2015) Dejaco et al. : https://www.rheumatology.org/Portals/0/Files/2015%20PMR%20guidelines.pdf Über Medizinmensch: Medizinische Informationen für Alle. Deutschsprachige Videos mit Untertiteln. Twitter: https://twitter.com/Medizinmensch Folge direkt herunterladen

David Rosenblum, MD is a Brooklyn and Great Neck Pain Physician at AABP Integrative Pain Care.  For a Telehealth or In Person appointment, go to AABPPain.com or call Brooklyn     718 436 7246 Great Neck 516 482 7246

On this Episode, number 93, of the “Just Bein’ Honest Podcast”, tears are shed yet once again. I cannot hide my pain all the time. This time it is physical pain in my extremities. SAUSAGE FINGERS!!! Swollen joints. Pins and NEEEEDLESSSSS!!! I have and most often do, SMILE through the PAIN, but I wanted to let you all know that it's okay to feel it out sometimes : ) We are all fighting a battle. Mine is morphing in to many camouflage of symptoms and is OH so annoying, BUT I am always about the root of the situation...so here we go! On this episode I will share a little story of when this all started and some environmental toxins that along the way have made it worsen. I also share some common type of AutoImmune Responses - see below. PLEASE, DO NOT GUESS YOURSELF AS HAVING ONE OF THESE! Seek professional help - always get 2-3 set opinions! Most common types of AutoImmune Disease Includes: Rheumatoid arthritis: A chronic inflammatory disorder affecting many joints, including those in the hands and feet. Lupus: An inflammatory disease caused when the immune system attacks its own tissues. Celiac disease: An immune reaction to eating gluten, a protein found in wheat, barley, and rye. Sjögren's syndrome: An immune system disorder characterized by dry eyes and dry mouth. Polymyalgia rheumatica: An inflammatory disorder causing muscle pain and stiffness around the shoulders and hips. Multiple sclerosis: A disease in which the immune system eats away at the protective covering of nerves. Ankylosing spondylitis: An inflammatory arthritis affecting the spine and large joints. Type 1 diabetes: A chronic condition in which the pancreas produces little or no insulin. Alopecia areata: Sudden hair loss that starts with one or more circular bald patches that may overlap. Vasculitis: An inflammation of the blood vessels that causes changes in the blood vessel walls. Temporal arteritis: An inflammation of blood vessels, called arteries, in and around the scalp. ** What do you have to give up in order to continuously grow. Remember, everything is a CHOICE!!!* Turn up the volume and grab your notepads, because you just turned on the “Just Bein’ Honest” Podcast. —————————— To all of my JBH listeners and supporters, I hope you all got a lot of value out of this episode today, and thank you so much for hanging out with me. And if you did, please make sure to share this out with your friends and family on social media, and you can tag me @JustBeinHonestKB , I’m so grateful of your support and love to see that. And please make sure to head over to iTunes to SUBSCRIBE to the “Just Bein’ Honest” Podcast, and leave us a rating to let everybody know that the show is fabulous. You have the power to help us bring to you even better content and guests each and every week! And as always I appreciate you so much, until next time, thanks for joining in. Please note: Remember, "Disease SPEAKS". (Disease or DIS-EASE). And ALWAYS remember to listen to your body, what is it telling you? It’s that time to turn up the “Just Bein’ Honest” Podcast and allow me to fill you with strength and satiation! SCROLL DOWN for a FREEBIE!!! ————————————————— Follow ME - "KB" on my journey through LIFE: @JustBeinHonestKB + Just Bein' Honest Kiss Kiss, Hug Hug - Much of Many my little honesters! This is True Food for Thought + I'm Just Bein' Honest... Always. xoxo kb Please subscribe to our PODCAST on iTunes and give us a 5 star rating - We would be honored and so grateful. www.JustBeinHonest.com Show Sponsor : JUST BEIN' HONEST (KB's LIFESTYLE DESIGN) Today’s Podcast of the “Just Bein’ Honest” Podcast is brought to you by JUST BEIN' HONEST (KB's LIFESTYLE DESIGN) ! JUST BEIN' HONEST (KB's LIFESTYLE DESIGN) wants you to know that "DISEASE" stems from always trying to PLEASE, but the SOUL is where your truth speaks. When you let your soul be the guide, that is when you are at your most powerful. I (KB) am your lifestyle designer. Your advisor for - HEALTH, WELLNESS, TRAVEL and DOMESTIC everyday LIFESTYLE PRACTICES. I unveil your TRUTH and the choices you have to cultivate the life that you want. Are you ready to live your most AUTHENTIC and WELL-CURATED LIFESTYLE? I'd like to offer you a head-start on your journey toward healthy and authentic living. Say - "JBHFREE" - when you schedule your first appointment and receive your FIRST DISCOVERY CALL - - - FREE! {Please send me an E-mail to get started today!} katherine@justbeinhonest.com Get the GLOW with my favorite skincare line from AMINA ADEM! Want to start the anti-aging process now? Perhaps just love the biggest organ on your body in to natural health? I give to you 10% OFF with code JBH10 - ENJOY!!! {Please send me an E-mail for more JBH INSIDER deals!} katherine@justbeinhonest.com

In this episode I cover polymyalgia rheumatica.If you want to follow along with written notes on polymyalgia rheumatica go to https://zerotofinals.com/medicine/rheumatology/pmr/ or the rheumatology section in the Zero to Finals medicine book.This episode covers the definitions, associations, features, diagnosis and management of polymyalgia rheumatica. We also cover long term steroids.The audio in the episode was expertly edited by Harry Watchman.

Joining us today, we have Dr. Ferris, navigating us through the diagnosis of PMR & GCA.

Shownotes Jeff: Welcome back to EMplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta. This month, we’re tackling an incredibly important topic - evaluation and management of life threatening headaches in the Emergency Department. Nachi: Fear not, this will not simply be “who needs a head CT episode”; we’ll cover much more than that. Listen closely as this is an important topic, with huge consequences for mismanagement. Jeff: Absolutely. As some quick background - headaches account for 3% of all ED visits in the US, with 90% being benign primary headaches and less than 10% being secondary to other causes like vascular, infectious, or traumatic etiologies. It’s within these later 10% that we are looking for the red flag signs to identify the potentially life-threatening headaches. Nachi: And to do so, Dr. David Zodda and Dr. Amit Gupta, PD and APD at Hackensack University Medical and Trauma Center, and their colleague Dr. Gabrielle Procopio, a PharmD, have done a fantastic job parsing through the literature, which included over 500 abstracts, 89 full text articles, guidelines from ACEP and the American Academy of Neurology, as well as canadian and european neurology guidelines, to summarize the best evidence based recommendations for you all. Jeff: We would be remiss to not also mention Dr. Mert Erogul of Maimonides Medical Center and Dr. Steven Godwin, Chair of Emergency Medicine at the University of Florida College of Medicine. Nachi: Alright, so let’s get started with some definitions and pathophysiology. The international classification of headache disorders 3, or ICHD-3, classifies headaches into primary, secondary, and cranial neuropathies. Jeff: Primary headache disorders include migraine, tension, and cluster headaches. Secondary headaches include those secondary to vascular disorders, traumatic disorders, and disorders in hemostasis. These are the potentially life threatening headaches that can have a mortality has high as 50%. Nachi: And the final category includes cranial neuropathies, such as trigeminal neuralgia. Jeff: And I think we can safely say that that wraps up our discussion in this episode on cranial neuropathies, moving on…. Nachi: Headaches result from traction to or irritation of the meninges and blood vessels, which are the only innervated central nervous system structures. Activation of specific nerve ganglion complexes by neuropeptides like -- substance P and calcitonin gene-related peptide -- are thought to contribute to head pain. Jeff: It is important to note that all headache pain shares common pain pathways, thus response to pain medications does not exclude potential life threatening secondary causes of headache. This led to the ACEP guideline which states just that.. Nachi: I feel like that deserves ding sound as it's a critically important point. To repeat, just because a pain medication relieves a headache, that does not exclude dangerous secondary causes! Jeff: And what are the life threatening headaches? Life-threatening headaches include subarachnoid hemorrhage, cervical Artery Dissection, which includes both vertebral Artery Dissection and carotid artery dissection, cerebral Venous Thrombosis, idiopathic intracranial hypertension, giant cell arteritis, and posterior reversible encephalopathy syndrome, or PRES. Nachi: Slow down for a second and let’s not skip over your favorite section.. Let’s talk pre hospital care for headache patients. Jeff: Good call! Pre-hospital care is fairly straightforward and includes a primary survey, conducting a focused neurologic exam, and assessing for red flag signs, which include focal neurologic deficits, sudden onset headache, new headache in those over 50, neck pain or stiffness, changes in visual Acuity, fever or immunocompromised State, history of malignancy, pregnancy or postpartum status, syncope, and seizure. That’s quite a list. For a visual reference, see Table 3 in the print issue. Nachi: And patients with neurologic deficits or severe sudden-onset headaches, should be transported immediately to the nearest available stroke center. Tylenol should be offered for pain management. Avoid opioids and nsaids. Jeff: Upon arrival to the emergency department, history and physical should include your standard vitals, testing neurologic function, cranial nerve testing, head and neck exam, as well as a fundoscopic exam. As was the case for your pre-hospital colleagues, you should also assess for red flag signs for life-threatening headaches. Check out tables 2, 3, and 4 for more details here. Nachi: With respect to Vital Signs, in the setting of an acute headache, severe hypertension should prompt a search for signs of end-organ damage such as hypertensive encephalopathy, intracranial Hemorrhage, PRES, and preeclampsia in pregnant women. Additionally, fever, and especially fever and neck stiffness, should raise concern for CNS infection. Jeff: For your neurologic examination, make sure to include assessments of motor strength, coordination, reflexes, sensory function, and gait. Don't forget that lesions involving the anterior circulation, such as dysarthria, cognitive impairment, and Horner syndrome may be indicative of a carotid artery dissection, whereas dizziness, vision changes, and limb weakness may be due to a vertebral Artery Dissection. Nachi: And for cranial nerve testing - pay particular attention to cranial nerves 2, 3 and 6. For cranial nerve 2 - look out for an afferent pupillary defect, or a marcus-gunn pupil, which is seen in optic neuritis, giant cell artertitis, and central retinal artery occlusion. For CN3, oculomotor nerve palsies raise concern for a posterior communicating aneurysm and SAH. And lastly, CN6 palsies, which often presents with diplopia on lateral gaze , are often seen with intracranial idiopathic hypertension and cerebral venous thrombosis, in addition to impaired visual acuity, visual field defects, and tunnel vision. Jeff: For the head and neck exam, remember that a partial horner syndrome, with miosis and ptosis without anhidrosis, may be indicative of a cervical artery dissection. Unfortunately, if the patient presents acutely, their only complaint may be pain, as the neurologic sequelae may take days to develop. Nachi: Additionally, with respect to the head and neck exam, evaluate the patient for tenderness and beading along the temporal artery. Jeff: One review noted that temporal artery beading actually had the highest likelihood ratio for GCA, 4.6, whereas temporal artery tenderness only had a LR of 2.6 Nachi: And the last physical exam maneuver you should ideally perform is a fundoscopic exam for papilledema, which is often seen in IIH, malignant hypertension, and CVT. Jeff: Perfect so that rounds out the physical, next we have diagnostic studies. Most importantly, routine lab testing is typically of low utility in aiding in the diagnosis of headache. Nachi: Even ESR and CRP in the setting of possible giant cell arteritis have poor sensitivity and specificity to diagnose it. So even if the ESR and CRP are negative, if the suspicion for GCA is high enough, it should be treated and you should get a biopsy. Jeff: Do consider adding on a venous or arterial carboxyhemoglobin in the right clinical scenario, as CO poisoning represents an important cause of headache you wouldn’t want to miss. This is especially important at this time of year when heating systems are working overtime here in the states. Nachi: And hopefully you have a co-oximeter, so you can even check this non-invasively. Jeff: Interestingly, there may be a unique role for a d-dimer here as well. Several small studies have used the d-dimer to risk stratify patients with possible CVT. In one study a d-dimer level < 500 mcg/L had a 97% sensitivity and a negative predictive value of 99% - not bad! Nachi: Pretty impressive performance characteristics. I think that about wraps up lab work. Let’s talk radiology. Jeff: Though low yield, CT utilization is estimated at 2.5-10% of non-traumatic headaches. A non-con CT should be reserved for those with suspicion for an intracranial hemorrhage, while a contrast CT would be required in those in whom there is concern for an infectious process or space occupying lesion. Nachi: CT angio or MRI should be used in cases of possible cervical artery dissection. MRI also is the neuroimaging of choice for PRES, which is more sensitive for cerebral edema than CT. Jeff: Similarly, MRV is recommended in those with a concerning story for CVT. Nachi: To help guide your emergent neuroimaging utilization, ACEP suggests imaging in those with headache and an abnormal finding on neuro exam, those with new and sudden-onset severe headache, HIV positive patients with new headache, and those over 50 with a new headache. Jeff: With that in mind, let’s dive a bit deeper into the use of CT for SAH, a topic which doesn’t get a ding sound, but is certainly critically important. Recent literature have found that a CT within 6 hours of symptom onset has a sensitivity and specificity and negative predictive value of 100%. In addition, one 2016 study demonstrated a LR of 0.01 in those with a negative HCT within 6 hours. These are really important results because that means SAH is essentially ruled out with a negative study. Nachi: Unfortunately, the 2008 ACEP guideline and 2012 AHA guidelines still recommend a lumbar puncture in those being worked up for SAH. Luckily the ACEP guideline is currently being revised so your decision to forego the LP with a negative HCT in the first 6 hours will likely also be backed by ACEP in the near future. Jeff: That’s a nice transition into our next test - the LP. Since LP carries a risk of herniation, in those with signs of increased ICP, make sure to get appropriate neuroimaging before attempting the puncture. In those without signs of increased ICP, no imaging is necessary. Nachi: While the position in which the LP is performed doesn’t matter as much when ruling out infection or SAH, in those with suspected IIH, make sure to obtain an opening pressure with the patient lying in the lateral decubitus position. An opening pressure of greater than 25 is often seen in IIH. Jeff: And the LP in the setting of IIH is not only diagnostic but also potentially therapeutic, as the removal of 1 ml of CSF can lower the pressure by 1 cm of H20 and potentially relieve the patient’s symptoms. Nachi: Always rewarding to diagnose and treat simultaneously... Jeff: Absolutely. But back to the LP for SAH for a second or two. When evaluating for a subarachnoid hemorrhage, you’ll often note an opening pressure of greater than 20 with persistent RBC in all tubes. Nachi: While there are no RBC cutoffs, one study found no patients with a SAH with less than 100 RBC in the final tube. In contrast, greater than 10,000 RBC increased the odds by a factor of 6. In addition, one 2015 study found that patients without xanthrochromia and less than 2000 RBC were effectively ruled out of having a SAH with a combined sensitivity of 100% Jeff: Lots of 100% sensitivities and specificities being thrown around today, which is definitely not the norm. No complaints here, I’ll take it. Anyway, the last test to discuss is our good friend the ultrasound, specifically the ocular ultrasound. Nachi: Examining the optic nerve sheath 3 mm posterior to the globe, an optic nerve sheath diameter of 5 mm or greater is predictive of an ICP greater than 20. Jeff: Keep in mind that this may expedite the work up, though a normal diameter does not rule out increased ICP, so a head CT may still be indicated. Nachi: Alright, so we’ve talked a lot about testing, both lab and imaging, and we’ve mentioned a bunch of pathologies, but let’s spend a few minutes going over the specifics of each. Jeff: Let’s start with SAH. SAH account for 1% of all headache visits to the ED. Most nontraumatic SAH are caused by aneurysm rupture. A missed diagnosis of SAH can have a case-fatality rate as high as 50% Nachi: Although 75% of SAH patients report an abrupt onset, objective neck stiffness has the highest likelihood ratio of 6.6. Other important features include LOC, neurologic deficit, subjective neck stiffness, photophobia, and onset during exertion or intercourse. Jeff: Additionally, approximately 20% of patients with a SAH have warning signs of a sentinel bleed including headaches, cranial nerve palsies, neck pain, or nausea and vomiting. Nachi: In order to aid you in diagnosing a SAH, you should consider the ottawa SAH Rule which has a 100% sensitivity and a 15% specificity. To use this rule you must be between 15 and 40 with a GCS of 15 and present with a headache with maximal intensity within 1 hour of onset. If you meet those inclusion criteria, and you have no neurologic deficits, no neck pain or stiffness, no witnessed LOC, no onset during exertion, no limitation of neck flexion, and no thunderclap onset, you can essentially rule out a SAH. Jeff: While the ottawa SAH rule has been prospectively validated, know that this study has been challenged for its interobserver variability, but in any case it still provides helpful red flags to consider. If your patient is found to have a SAH, a CT angiogram and neurosurgical consultation should be considered immediately. Nachi: In addition to monitoring ABCs, early care involves the administration of analgesics and anti-emetics. Also consider elevating the head of the bed to 30 deg, which may also improve venous drainage and decrease ICP. Jeff: In terms of BP management, guidelines from the american stroke association recommend targeting a SBP of 160 with a titratable agent like nicardipine or clevidipine. Nachi: In addition, nimodipine, 60 mg q4h, should be given to those with aneurysmal SAH to improve outcomes. Jeff: and any role for anti-epileptics? Nachi: That’s controversial and the authors state it may be considered in the immediate post-hemorrhagic period and should be limited to a 3-7 day course with longer courses required in special populations. Jeff: The next pathology to discuss is cervical artery dissections, which account for 2% of all strokes and nearly 20% of strokes in those 50 and under. cervical artery dissections are most commonly due to trauma, but can occur spontaneously. Nachi: Risk factors include Ehlers-Danlos syndrome, osteogenesis imperfecta, and Marfan syndrome. Jeff: Regardless of the etiology, the management of cervical artery dissections is primarily medical with IV heparin followed by warfarin or a direct oral anticoagulant in those with extracranial dissections, and antiplatelet therapy like aspirin or clopidogrel in those with intracranial dissections. Nachi: Thanks to the CADISP study, we know there is no difference in mortality or neurologic outcome when choosing between antiplatelet therapy and anticoagulation. Jeff: Next we have cerebral venous thrombosis. This typically presents with a gradual onset headache. Though it can happen to anybody, cerebral venous thrombosis typically results from thrombotic disease. Nachi: Important risk factors include oral contraceptive use, pregnancy and postpartum states, Factor V Leiden deficiency, and lupus. Jeff: Treatment for CVT is controversial due to a high risk of hemorrhage and hemorrhagic transformation. According to the best available evidence, anticoagulation is the standard therapy with full dose anticoagulation of low-molecular weight heparin or heparin as a bridge to warfarin. Nachi: Yeah, it’s really a tough spot to be in as one third end up having some form of hemorrhage too…. Jeff: Perhaps yet another good place for shared decision making? Nachi: Honestly, it’s a good thought, but anticoagulation is the guideline recommendation, so I think that is likely the best route in this case. Jeff: Great point. Next we have idiopathic intracranial hypertension. This is typically associated with obese women of childbearing age. It may also be due to hypervitaminosis A from excessive dietary intake and even drugs like the retinoids used in treating dermatologic conditions and cancers. Nachi: idiopathic intracranial hypertension can be diagnosed by the modified dandy criteria which are found in table 8 on page 11. Let’s just run through the criteria. Jeff: The modified Dandy criteria for idiopathic intracranial hypertension include: signs and symptoms of increased ICP, no other neurologic abnormalities or altered level of consciousness, ICP > 20 on LP with normal CSF composition, neuroimaging without another etiology for intracranial hypertension, and lastly no other identified cause of intracranial hypertension. Nachi: And as we mentioned a few minutes ago, an LP can be both diagnostic and therapeutic, though the relief is likely temporary Jeff: For more permanent treatment, weight loss is the key. Acetazolamide, 250 mg to 500 BID is the first line pharmacotherapy. Combined with weight loss, acetazolamide and a low sodium diet has been shown to improve visual field function. Nachi: And if this fails, topiramate, furosemide, and in the worst case surgical options like CSF shunting, venous sinus stenting, and optic sheath fenestration are all options. Jeff: I imagine taking a diuretic for a headache could be a real hindrance on quality of life, though I suppose it’s better than risking vision loss or having a significant neurosurgery. Nachi: Agreed. Next we have giant cell arteritis. GCA is rare, with a prevalence of

Dr Andrew Boyden interviews Dr David Liew about the aetiology, pathophysiology and management of polymyalgia rheumatica.

In this presentation, Dr. Lyn Shue presents Polymyalgia, Polymyositis, and Fibromyalgia by discussing pathophysioloy, site, weakness, pain, lab and Rx. She does this though the use of scans and medical illustrations. She also discusses treatment approaches, diagnostic approaches, and management.   Some items in this lecture may have come from the lecturer’s personal academic files or have been cited in-line or at the end of the lecture. For more information, see our citation page. Disclaimers ©2016 LouisvilleLectures.org

Keep your cool in the face of inflammation, and make the path to vasculitis diagnosis less tortuous with Dr. Rebecca Sharim, Rheumatologist and Assistant Professor of Medicine at Temple University. In this episode, we go with the flow from large vessel to small vessel vasculitides, and then learn how to make the diagnosis and management of Giant Cell Arteritis (GCA) and polymyalgia rheumatica (PMR) less of a headache. Correspondent, Dr. Bryan Brown cohosts!  Special thanks to Dr. Bryan Brown for writing our show notes, and creating figures for our handouts. Full show notes available at http://thecurbsiders.com/podcast Join our mailing list and receive a PDF copy of our show notes every Monday. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case from Kashlak Memorial:  A 75 year-old woman with a PMHx of hypertension presents to the ED with three days of worsening left sided headache, now with left sided vision loss during a Norwegian folk festival. On review of systems, she also endorses a week of soreness of her shoulders and hips. This has never happened to her before. Time Stamps 00:00 Intro 03:07 Picks of the week 09:13 Getting to know our guest 15:00 Clinical case of vasculitis 15:59 Defining and classifying vasculitis 20:55 Workup for suspected vasculitis 23:17 How to explain GCA to a patient 25:08 Typical symptoms of vasculitis 28:00 Chewing gum test 29:34 Interpreting ESR 32:54 Basic exam and lab workup for vasculitis 35:23 Headache and suspicion for GCA/temporal arteritis 38:10 Is a temporal artery biopsy still mandatory? 39:20 Polymyalgia rheumatica 40:59 Steps to take when GCA/temporal arteritis suspected in clinic 43:55 PCP prophylaxis with high dose steroids 46:30 DMARDs and steroid sparing agents 48:12 Imaging studies to aid in diagnosis of GCA 50:50 Complications of long term steroid therapy 52:31 Take home points 53:26 Outro Tags: giant, cell, arteritis, gca, vasculitis, steroids, temporal, biopsy, artery, esr, pmr, polymyalgia, rheumatica, vessel, headache, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, meded, medical, medicine, practitioner, professional, primary, physician, resident, student

Editor's Audio Summary by Howard Bauchner, MD, Editor in Chief of JAMA, the Journal of the American Medical Association, for the June 14, 2016 issue

Beebs @BeebsMoney is back on the show and we get to hear her brand new solo song, Ride Around the Sun. Amidst our talk on music, business and more she let us in on a very personal subject on her health and life.  Living in pain from Polymyalgia/Fibromyalgia. I was blown away. Had no idea. Learn about it in this episode. We also cover a few other very interesting topics including:Routines, Float Tanks, Meditation for people who don't meditate, Music Business, Cannabinoids/CBD/Medicinal Cannabis, iOS update fail - Night Shift, Twitter Freeze Out, Tron Bikes/NASA/SpaceX Visit her band site for more fun - BEEBS WEBSITE: http://beebsandhermoneymakers.com/ Beebs and Her Money Makers were discovered by legendary promoter Kevin Lyman and asked to join the Vans Warped Tour 2013. As they performed all 50+ days of the summer, Beebs and Her Money Makers were filmed for the 2nd Season of Warped Roadies on the FUSE Network.

This year The BMJ has chosen Doctors of the World as it's Christmas appeal. This week we hear about the charity's international work. Deputy magazine editor Richard Hurley talks to some of the doctors who are working in Syria and the camps surrounding the stricken country. Also this week, a clinical review on BMJ.com looks at polymyalgia rheumatica. Clinical reviews editor Sophie Cook asks Sarah Mackie, from the Leeds Institute of Rheumatic and Musculoskeletal Medicine, how she explains this difficult condition to patients. After the typhoon: how volunteer doctors are bringing medical care to those most in need http://www.bmj.com/content/347/bmj.f7193 Polymyalgia rheumatica http://www.bmj.com/content/347/bmj.f6937

Die Riesenzellarteriitis (RZA) ist die am häufigsten vorkommende Form der primären Vaskulitiden und betrifft nahezu ausschließlich Patienten über 50 Jahre (WEYAND und GORONZY 2003). Trotz ihres systemischen Charakters sind verschiedene Gefäßregionen in unterschiedlichem Ausmaß von der RZA betroffen. Am häufigsten ist das kraniale Befallsmuster (SALVARANI et al. 2008). Klinisch apparente Komplikationen im Bereich der extrakraniellen großen Arterien wurden in bis zu 27% der Fälle beobachtet, mit dem Erscheinungsbild der symptomatischen Armischämie in 10 bis 15% der Fälle (KLEIN et al. 1975; NUENNINGHOFF et al. 2003). Jedoch besteht die Vermutung, dass extrakranielle Manifestationen der RZA bislang in Häufigkeit und Relevanz unterschätzt wurden (TATO und HOFFMANN 2008) Ziel dieser Arbeit war die Evaluation der Beteiligung der extrakraniellen Anteile der Karotiden und der proximalen armversorgenden Arterien bei RZA mithilfe der Farbduplexsonographie (FDS). Dazu wurden 88 konsekutive Patienten (Alter 69,0 + 8,1 Jahre; 72,2% Frauen) mit Erstdiagnose einer RZA zwischen 01/2002 und 06/2009 neben der klinisch-angiologischen und laborchemischen Diagnostik einer farbduplexsonographischen Untersuchung der supraaortalen Arterien unterzogen. Eine konzentrische, echoarme Wandverdickung der entsprechenden Gefäße wurde dabei als vaskulitistypisch gewertet (SCHMIDT et al. 2008). Patienten mit extrakranieller Riesenzellarteriitis (G-RZA) und Beteiligung der supraaortalen Arterien sowie Patienten mit isolierter kranialer Riesenzellarteriitis (AT) wurden bezüglich klinischer Charakteristika vergleichend betrachtet, ebenso die klinischen Besonderheiten verschiedener Altersgruppen des Patientenkollektivs. Bei 40 Patienten (45,5% des Gesamtkollektivs) konnte eine G-RZA mit Beteiligung der proximalen Armarterien diagnostiziert werden, welche nahezu ausschließlich (97,4%; 44,3% des Gesamtkollektivs) bilateral auftrat und bei 23 Patienten (57,5%; 26,1% des Gesamtkollektivs) zu Stenosen oder Verschlüssen führte. Am häufigsten war die A. axillaris (AAX) (85%; 38,6% des Gesamtkollektivs) involviert, gefolgt von A. subclavia (ASUB) (57,5%; 26,1% des Gesamtkollektivs). Eine Beteiligung der Karotiden lag bei 20 Patienten (50%; 22,7% des Gesamtkollektivs) vor, von denen 19 Patienten (95%; 21,6% des Gesamtkollektivs) auch eine Beteiligung der Armarterien aufwiesen. Wiederum fanden sich auch in dieser Gefäßregion bei einem Großteil der Patienten bilaterale Veränderungen (80%; 18,2% des Gesamtkollektivs), während Lumenobstruktionen selten waren (15%; 3,4% des Gesamtkollektivs). Am häufigsten war die A. carotis communis (ACC) beteiligt (80%; 18,2% des Gesamtkollektivs). Durch die Kombination der FDS der proximalen Armarterien mit den etablierten Diagnosekriterien des American College of Rheumatology (ACR) für die Diagnose der AT hätten alle Patienten dieser Serie identifiziert werden können. Eine zusätzliche duplexsonographische Untersuchung der Karotiden oder der A. temporalis superficialis (ATS) hätte keinen weiteren diagnostischen Nutzen erbracht. Durch alleinige Berücksichtigung der ACR-Kriterien hätten nur 20 Patienten mit G-RZA (48,8%) diagnostiziert werden können. Patienten mit G-RZA waren im Durchschnitt signifikant jünger als Patienten mit isolierter AT (72,3 + 7,5 versus 65,2 + 7,1 Jahre) und zeigten seltener die klassischen kranialen Symptome (100% versus 53,7%) einschließlich permanentem Visusverlust (51,1% versus 4,9%). Während eine Beteiligung der Karotiden immer klinisch stumm ablief, führte die G-RZA der Armarterien bei 13 Patienten (31,7%) zu einer symptomatischen Armischämie. Die Zeit bis zur Diagnose war bei Patienten mit G-RZA signifikant länger (24,2 + 21,5 versus 7,1 + 8,4 Wochen). Bei 84,2% der Patienten älter 70 Jahre führten die klassischen Symptome einer AT zur Diagnose, verglichen mit nur 44,0% der Patienten jünger 70 Jahre (p < 0,01). Diese wiesen häufiger konstitutionelle Symptome (66% versus 36,8%, p < 0,05) und die Symptome einer Polymyalgia rheumatica (PMR) (46% versus 21,1%, p < 0,05) auf. Infolgedessen war die Zeit bis zur Diagnose bei Patienten < 70 Jahre signifikant länger (18,2 + 20,1 versus 10,3 + 3,1 Wochen, p < 0,05), wohingegen Patienten > 70 Jahre wesentlich häufiger von permanenten Visusstörungen (8% versus 57,9%, p < 0,01) betroffen waren. Zusammenfassend wurde eine Beteiligung der Karotiden und/ oder der Armarterien bei nahezu jedem zweiten Patienten mit RZA gefunden. Die FDS der leicht zugänglichen proximalen Armarterien stellt nach den Ergebnissen dieser Untersuchung in Ergänzung zu den etablierten Diagnosekriterien der AT eine wertvolle diagnostische Methode in der Diagnostik der RZA dar und sollte in der klinischen Routine eingesetzt werden. Insbesondere jüngere Patienten (50-69 Jahre), die häufiger eine extrakranielle Beteiligung und seltener das klassische kraniale Befallsmuster aufweisen, können unter Nutzung dieses Verfahrens identifiziert werden.

Kraniozervikale Arterien sind bei der Riesenzellarteriitis sehr häufig befallen. Viele von ihnen sind für die Ultraschalldiagnostik einfach zugänglich und nichtinvasiv langstreckig untersuchbar. Mit Einführung der hochauflösenden farbkodierten Duplexsonographie ist die Beschallung der kleinlumigen Arterien möglich, die für die Diagnose der Riesenzellarteriitis routinemäßig bioptisch-histologisch untersucht werden. Um die diagnostische Bedeutung der Ultraschalldiagnostik der kraniozervikalen Arterien für die klinische Praxis zu bewerten, wurden die Ergebnisse dieser Diagnostik bei 317 Patienten ausgewertet, bei denen in den Jahren 1998 bis 2006 im Klinikum Augsburg die kraniozervikalen Arterien mit der Fragestellung „Riesenzellarteriitis“ sonographisch untersucht wurden. Wie die ACR-Kriterien zeigen, gelingt es, durch eine Kombination von mehreren charakteristischen Merkmalen die Sensitivität und Spezifität der Diagnostik der Riesenzellarteriitis im Vergleich zur Berücksichtigung einzelner Kriterien, wie etwa der Biopsie, deutlich zu verbessern. Es wurde deshalb ein Punkte-Score für die Diagnose der RZA entwickelt der auf der Ultraschalldiagnostik beruht und die Biopsie nicht benötigt. Als optimal und zugleich für die klinische Praxis am besten geeignet erwiesen sich für diesen Score die folgenden klinischen Symptome bzw. Befunde: Kauschmerz, Kopfschmerz, Sehstörungen, auffälliger Tastbefund der A. temporalis superficialis bzw. occipitalis, Vorliegen einer Polymyalgia rheumatica (PMR) entsprechend den Bird-Kriterien, erhöhte Werte der Blutkörperchen-Senkungsgeschwindigkeit (BSG) oder des C-reaktiven Proteins (CRP) sowie ein positiver Befund in der Ultraschalldiagnostik. Damit die Diagnose einer RZA bzw. AT gestellt werden kann, müssen mindestens drei dieser sieben Kriterien erfüllt sein. Außerdem muss mindestens eines von vier Hauptkriterien vorliegen. Dieser „Ultraschall-Score“ hat hinsichtlich der Diagnose einer RZA eine Sensitivität von 81,4 %, eine Spezifität von 91,3 % und eine Effizienz von 85,9 %. Werden die large-artery Variante und die okkulte Form der RZA als schwer zu diagnostizierende atypische RZA-Unterformen ausgeschlossen und beschränkt man sich ausschließlich auf die Diagnose der AT, so erhöhen sich die Sensitivität des „Ultraschall-Scores“ auf 89,9 und die Effizienz auf 90,6 %. Er erreicht damit die Validität der ACR-Kriterien, die in unserem Patientenkollektiv eine Effizienz von 85,9 % bzw. 90,1 % haben.