A 70-year-old woman presents with weight loss of 3kg, vague headaches, aching all over the body and morning stiffness of the shoulder and hip girdles.

Subject
Medicine
System
Rheumatology/Orthopedics & Sports

Kathryn

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Jul 29, 2020
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A 70-year-old woman presents with weight loss of 3kg, vague headaches, aching all over the body and morning stiffness of the shoulder and hip girdles. These symptoms have been present for the past six months. Physical examination is normal, except for some tenderness in the muscles of her shoulder. Investigations show a normochromic normocytic anaemia, erythrocyte sedimentation rate (ESR) of 65 mm/h (5-20) and raised C-reactive protein. All other investigations, including muscle enzymes, are normal. Which one of the following is the most likely diagnosis?
(A) Multiple myeloma
(B) Polymyalgia rheumatica
(C) Rheumatoid arthritis
(D) Occult malignancy
(E) Polymyositis
 
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