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  #1  
Old 07-10-2011
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Rheumatology/Orthopedics Neck and Hip Girdle Pain + Morning Stiffness

A 58-yr-old female patient presents with neck and hip girdle pain since few weeks. She also complains that she could not get up from sitting position. Pain worse at night. Early morning she feels stiffness in joint which lasts for a very long period. ESR and CRP is elevated. Synovial fluid is normal. creatine phosphokinase is normal. Most probable diagnosis is?
1. Polymyalgia rheumatica
2. Hypothyroidism
3. Fibromyalgia
4. Polymyosities
5. Paraneoplastic syndrome
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  #2  
Old 07-10-2011
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im gonna have to say polymyositus cuz of the proximal muscle weakness, morning stiffness , and inc in ESR and CPK .
EDIT

hold it one second i just re read the question and saw it was CRP not CPK in that case il go for polymyalgia rheumatica
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  #3  
Old 07-11-2011
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I m withPolymyalgia rheumatica...It has characteristic pain hip neck pain, morning stifness which make them unable to get up from sitting position..treatment low dose cortizone
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Old 07-11-2011
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My answe is 3 Polymiositis
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Old 07-11-2011
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Quote:
Originally Posted by aksyonez View Post
My answe is 3 Polymiositis

but cpk is nomal
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Old 07-11-2011
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i'm with polymyalgia rheumatica, the character of pain is diagnostic along with increased esr, crp
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Old 07-12-2011
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1. Polymyalgia rheumatica typical

old with neck &hip girdle pain with morning stiffness >30 min and increase ESR &difficulty to raise from chair
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Old 07-12-2011
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Quote:
Originally Posted by confident View Post
A 58-yr-old female patient presents with neck and hip girdle pain since few weeks. She also complains that she could not get up from sitting position. Pain worse at night. Early morning she feels stiffness in joint which lasts for a very long period. ESR and CRP is elevated. Synovial fluid is normal. creatine phosphokinase is normal. Most probable diagnosis is?
1. Polymyalgia rheumatica
2. Hypothyroidism
3. Fibromyalgia
4. Polymyosities
5. Paraneoplastic syndrome
Answer is : 1. female patient with shoulder and girdle pain and stiffness early morning>1 hr.. indicates polymyalgia rheumatica.

2. Hypothyroidism: Delayed deep tendon reflex, cpk elevated.

3. Pain is present through out body and ESR and CRP are normal.

4. Proximal muscle first followed by distal muscle are involved...facial rash(Heliotrope rash) is seen, ck elevated.

5. Its mainly due to immunological response to tumor..mostly neurological features seen.
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Old 07-12-2012
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Quote:
Originally Posted by confident View Post
Answer is : 1. female patient with shoulder and girdle pain and stiffness early morning>1 hr.. indicates polymyalgia rheumatica.

2. Hypothyroidism: Delayed deep tendon reflex, cpk elevated.

3. Pain is present through out body and ESR and CRP are normal.

4. Proximal muscle first followed by distal muscle are involved...facial rash(Heliotrope rash) is seen, ck elevated.

5. Its mainly due to immunological response to tumor..mostly neurological features seen.
POLYMYALGIA RHEUMATICA >>>>>>> pain + stiffness
POLYMYOSITIS >>>>>>>>> >>>>>>> pain + proximal weakness
MYOPATHY >>>>>>>>>>>>>>>>>>> weakness
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Old 07-12-2012
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1. Polymyalgia rheumatica

Next best step>>>>>>>>>>> rule out temporal arteritis.
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  #11  
Old 07-12-2012
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Quote:
Originally Posted by Novobiocin View Post
1. Polymyalgia rheumatica

Next best step>>>>>>>>>>> rule out temporal arteritis.
polymyalgia rheumatica >> there is dramatic improvement on steroid within 24-48 hours if dosent you should look for alternative diagnosis or the dose is inadequate

- PMR may be develope to GCA so early dignosis and treatment important
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  #12  
Old 07-15-2012
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Polymyalgia Rheumatica.
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