It is important to realize that symptoms of polymyalgia rheumatica usually present with a fairly rapid onset of muscle aches. In general these are located in the neck, shoulder girdle muscles, upper arm muscles, hip muscles and upper thigh muscles.
In particular, a few days before these symptoms there may have been flu like symptoms. For instance, there would have been a lack of energy, a fever and malaise. Weight loss, signs of depression and stiffness after inactivity are also common.
It may appear that the patient is suffering from a cancer. But a thorough work-up usually fails to show any sign of cancer (Ref. 2). Polymyalgia rheumatica is a diagnosis by exclusion. In other words, any disease that has a similar presentation with muscle aches and pains such as depression, cancer or infection has to be excluded, before a diagnosis of polymyalgia rheumatica can be made by your doctor.
1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 14.
2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 50.
3. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
4. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
5. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
6. B. Sears: “The age-free zone”.Regan Books, Harper Collins, 2000.
7. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper Collins, 1997.