A 72-year-old woman has bilateral shoulder and hip girdle stiffness for several weeks, worse in the morning, with an ESR of 70 mm/hr and a dramatic response to low-dose prednisolone. What is the diagnosis?
Answer and explanation
Correct answer: B. Polymyalgia rheumatica
- Step 1: Proximal stiffness with raised inflammatory markers and a rapid steroid response is typical. Step 2. Polymyalgia rheumatica is associated with giant cell arteritis, so symptoms of headache or visual disturbance must be sought. Answer: Polymyalgia rheumatica. Why not the others: Polymyositis causes true weakness and a raised creatine kinase. Fibromyalgia has normal markers. Osteoarthritis does not give a marked inflammatory response.
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