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Polymyalgia rheumatica — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CarePolymyalgia rheumaticaUSMLE Step 3

A 71-year-old woman reports 6 weeks of bilateral shoulder and hip girdle aching with morning stiffness lasting 90 minutes. She has difficulty rising from a chair. There is no true weakness, rash, or synovitis. ESR is 62 mm/h and creatine kinase is normal. Which of the following is the most likely diagnosis?

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Correct answer: B — Polymyalgia rheumatica

Age over 50, proximal girdle pain and stiffness, elevated inflammatory markers, and normal creatine kinase are typical of polymyalgia rheumatica.

Reference: ACR/EULAR Polymyalgia Rheumatica Classification Guidance