fibromyalgia vs polymyositis vs polymyalgia rheumatica


Ddx
Clinical features Diagnosis
Fibromyalgia Young to middle-aged womenChronic widespread pain
Fatigue, impaired concentration
Tenderness at trigger points (eg, mid trapezius, costochondral junction)
>3 months of symptoms with widespread pain index or symptom severity score
Normal laboratory studies
Polymyositis Proximal muscle weakness (eg, increasing difficulty climbing up stairs)
Pain mild/absent
Elevated muscle enzymes (eg, creatine kinase, aldolase, AST)
Autoantibodies (ANA, anti-Jo-1)
Biopsy: Endomysial infiltrate, patchy necrosis
Polymyalgia rheumatica Age >50
Systemic signs & symptoms
Stiffness > pain in shoulders, hip girdle, neck
Association with giant cell (temporal) arteritis
Elevated ESR, C-reactive protein
Rapid improvement with glucocorticoids
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