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Polymyalgia rheumatica — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CarePolymyalgia rheumaticaUSMLE Step 3

A 72-year-old woman has 2 months of aching in both shoulders and hips with morning stiffness lasting 1 hour. Strength is preserved when pain is overcome. ESR is 68 mm/h and CK is normal. Which of the following is the most likely diagnosis?

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Correct answer: D — Polymyalgia rheumatica

Older age, proximal girdle pain and stiffness, elevated ESR, and normal CK support polymyalgia rheumatica.

Reference: ACR/EULAR PMR classification principles