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Polymyalgia rheumatica — RACP Adult Medicine MCQ

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EasyRheumatologyPolymyalgia rheumaticaRACP Adult Medicine

A 72-year-old man has 6 weeks of bilateral shoulder and hip girdle pain with morning stiffness lasting 90 minutes. CK is normal, ESR is 72 mm/h and there is no synovitis of small joints. He has no headache or jaw claudication. What is the most likely diagnosis?

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Correct answer: A — Polymyalgia rheumatica

Age over 50, proximal girdle pain, prolonged stiffness, high inflammatory markers and normal CK support polymyalgia rheumatica. Polymyositis would cause objective weakness and raised CK. Late-onset RA has synovitis, while fibromyalgia and rhabdomyolysis do not fit the inflammatory profile.

Reference: Therapeutic Guidelines (eTG) Rheumatology; AMH