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Diagnostic errors in polymyalgia rheumatica and temporal arteritis

J Bretza, P Prete, D Martin

    Southern Medical Journal
    |October 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

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    Persistent rapid ESR in polymyalgia rheumatica or temporal arteritis suggests other conditions. Consider lumbar spinal stenosis and Pancoast

    Area of Science:

    • Rheumatology
    • Oncology
    • Neurosurgery

    Background:

    • Polymyalgia rheumatica (PMR) and temporal arteritis (TA) are inflammatory conditions typically treated with corticosteroids.
    • Elevated erythrocyte sedimentation rate (ESR) is a key diagnostic and monitoring marker for PMR and TA.

    Observation:

    • Incomplete clinical response or a persistently high ESR despite corticosteroid therapy in patients with suspected PMR or TA warrants further investigation.
    • This clinical scenario can be complicated by alternative or co-existing diagnoses.

    Findings:

    • Lumbar spinal stenosis, a condition affecting the lower spine, can present with symptoms that mimic or obscure PMR/TA.
    • Pancoast's tumor, a type of lung cancer, can also present atypically and complicate the diagnosis of these rheumatologic conditions.

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    Implications:

    • Clinicians should maintain a high index of suspicion for alternative diagnoses when PMR or TA patients show poor response to treatment.
    • Considering uncommon conditions like lumbar spinal stenosis and Pancoast's tumor is crucial for accurate diagnosis and timely management.
    • This highlights the importance of a comprehensive diagnostic approach beyond initial inflammatory markers.