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Polymyalgia rheumatica — ABFM Board MCQ

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HardMusculoskeletal/Sports medicinePolymyalgia rheumaticaABFM Board

A 71-year-old man has shoulder and hip girdle aching with morning stiffness for 2 months. ESR is 68 mm/hr and CRP is elevated. He has no headache, jaw claudication, or visual symptoms. Which of the following is the most appropriate initial treatment?

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Correct answer: A — Low-dose prednisone with monitoring for giant cell arteritis symptoms

Polymyalgia rheumatica presents with proximal girdle pain and stiffness plus elevated inflammatory markers in older adults. Low-dose glucocorticoids are initial therapy, while symptoms of giant cell arteritis require urgent high-dose steroids.

Reference: ACR/EULAR Polymyalgia Rheumatica Recommendations