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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 72 mm/h and creatine kinase is normal. Which of the following is the most likely diagnosis?

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Correct answer: DPolymyalgia rheumatica

Proximal girdle pain and stiffness in an older adult with high ESR and normal CK is typical of polymyalgia rheumatica.

Reference: American College of Rheumatology PMR guidance: https://rheumatology.org/