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Polymyalgia rheumatica — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CarePolymyalgia rheumaticaUSMLE Step 3

A 74-year-old woman has 6 weeks of bilateral shoulder and hip girdle aching with morning stiffness lasting 90 minutes. She has difficulty rising from a chair. Strength is normal when pain is overcome. ESR is 68 mm/h and she has no visual symptoms. Which of the following is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Polymyalgia rheumatica

Older age, proximal aching and stiffness, elevated inflammatory markers, and preserved strength support polymyalgia rheumatica.

Reference: Current US clinical practice standards and USMLE Step 3 content outline, https://www.usmle.org/exam-resources/step-3-materials