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Polymyalgia rheumatica — USMLE Step 3 MCQ

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ModerateInternal Medicine (chronic management)Polymyalgia rheumaticaUSMLE Step 3

A 73-year-old woman has 2 months of bilateral shoulder and hip girdle aching with morning stiffness lasting 90 minutes. ESR is elevated. She has no true muscle weakness, rash, or joint erosions. Which of the following is the most likely diagnosis?

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Correct answer: APolymyalgia rheumatica

Older age, proximal girdle pain and stiffness, elevated inflammatory markers, and preserved strength suggest polymyalgia rheumatica.

Reference: ACR/EULAR Polymyalgia Rheumatica Recommendations