Polymyalgia rheumatica and temporal arteritis are still held to represent opposite poles of a single disease spectrum. In the former, girdle stiffness predominates; in the latter, frank vasculitis is demonstrable. Earlier reviews that were slanted at geriatricians in 1983 and 1993 both bemoaned the lack of an adequate diagnostic test and the differential diagnosis still remains particularly difficult in elderly people. Reviewing the situation after a further five years, this diagnostic confusion still exists, though there has been an increased recent interest in research into this condition. Although such endeavours have yet to help us diagnostically, the last five years have seen further insights into aetiopathogenesis as well as new approaches to treatment.