Polymyalgia Rheumatica: A Challenging Diagnosis in Elderly Patients - Case Reports

Abstract

Polymyalgia rheumatica (PMR) is often characterized by bilateral shoulder pain and can be accompanied by giant cell arteritis (GCA). Here we report 2 cases in which a PMR diagnosis was made. A 61-year-old man with a 1-month history of gait disturbance and bilateral shoulder pain after an infarct in the left cerebellum. Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) suggested PMR with GCA. A 78-year-old woman presented with alternating bilateral shoulder pain. She was repeatedly misdiagnosed with septic arthritis and treated with surgery. Based on clinical manifestations and laboratory tests, we retrospectively diagnosed her with PMR. We conclude that a careful analysis of the patient’s history and a meticulous examination is necessary for the correct diagnosis of PMR in elderly patients.