Polymyalgia Rheumatica: Or something else? Differential Diagnosis

Cardiovascular System (I00-I99).

Infectious and parasitic diseases (A00-B99).

Musculoskeletal system and connective tissue (M00-M99).

  • Chondrocalcinosis (synonym: pseudogout) – gout-like disease of the joints caused by deposition of calcium pyrophosphate in cartilage and other tissues; leads, among other things, to joint degeneration (often of the knee joint); symptomatology resembles an acute attack of gout; bilateral (bilateral) shoulder symptoms possible.
  • Dermatomyositis – rare collagenosis, which often occurs paraneoplastic.
  • Impingement syndrome of the shoulder – narrowing of the sliding space of the tendons of the rotator cuff muscles (group of four muscles whose tendons, together with the ligamentum coracohumerale, form a coarse tendon cap that encompasses the shoulder joint) and the shoulder bursa (bursa subacromialis) between the humeral head (upper end of the humerus bone) and the acromionNotes on the clinical picture: usually unilateral and no elevated inflammatory parameters.
  • Polymyositis – autoimmune disease from the series of collagenoses, which predominantly affects the musclesNotes on the clinical picture: less painful muscles and joints, rather sore muscles; CK increased in the active state.
  • Rheumatoid arthritis – chronic inflammatory multisystem disease that usually manifests as synovitis (inflammation of the synovial membrane); may be associated with bilateral (both sides) shoulder pain
    • Of older age (Elderly-onset RA [EORA] – may be associated with bilateral shoulder pain.
    • Seronegative rheumatoid arthritis of the elderly (Late Onset Rheumatoid Arthritis [LORA]) – onset with polymyalgic symptoms; inflammatory parameters usually not as high as in PMR.
  • Giant cell arteritis (RZA) – most common form of systemic vasculitis (inflammation of blood vessels) in patients over 50 years of age.
  • Statin-associated myalgias
  • Spondyloarthritis (chronic rheumatoid inflammatory systemic disease associated with inflammation in the spine) of advanced age

Neoplasms – tumor diseases (C00-D48).

  • Lymphomas – cancers of the lymphatic system.
  • Paraneoplastic myopathy – myalgias (muscle pain) that are a symptom of malignant (malignant) disease

Psyche – nervous system (F00-F99; G00-G99).

  • Parkinson’s disease

Further

  • Vitamin D deficiency