Surprised and Uncertain: Should I get a second opinion?

An ultrasound is not a specific criteria for PMR. It can show signs of
inflammation in some cases depending on the methods used.
Most important in addition to history is a trial of prednisone at appropriate
dosing. Lab work is not always sensitive for underlying autoimmune
activity. It can take time working with a rheumatologist to arrive at a
working diagnosis and treatment. Don’t give up. Stay involved in your care. Keep abreast of all your lab studies and records.
Consider a trial of anti-inflammatory Mediterranean diet.
Prednisone can ameliorate symptoms in various arthritic conditions,
but a one month therapeutic trial may be helpful .

Thank you. I will let myself exhale for a few weeks. But they will see me again if I don't decide to go to Hopkins. I'm about 45 min away and it may take awhile to get an appt...also, they want so much background material, it may take more of a life span than I have left to get it all together. I know they have access to all they need online...wish they'd get what they need.
I agree about the diet...I do eat very clean now, but can improve.
Can't take pred but am open to LDN and Celebrex.
Be well.

Blood tests for inflammation are the best determining factors for PMR. When those markers are elevated, in my case prednisone relieved totally. I began 20 mg in July 2023 and I am now completely off prednisone. I am 67 year old healthy female. I do still have aches and pains but nothing like the hip and shoulder muscle pain I first experienced. . This forum has helped me so much, hope it helps you. Good luck to you.

Hi Kate,
I am unable to take steroids, but there are other things to try. I'm glad this worked for you.
I had blood tests last month that showed normal range inflammation markers along with other labs that were also within normal parameters. In a few weeks, I'll be seeing my GP for annual checkup and will ask for these to be checked again along with CBC and other measurements I like to have reviewed.
Thanks and best health to you.

Huh?!!
I am know MD for sure, but I have been grilling Rheumatologists and Endocrinologists hard for 3 years, ... And I never heard of Ultra Sound as diagnostic tool for PMR.
As far as I know blood tests for the Sed-Rate and C-reactive Protein levels are the primary (almost sole) indicators of PMR.
When my GP suspected my symptoms were PMR he had me do those tests. And has they were "off the charts", gave me a referral to a Rheumatologist. And those two tests are what the Rheumatologist does to monitor the PMR.
I've got a history of construction, gymnastics, kickboxing, and surfing ..... so I have a fine collection of lasting body injuries .... And no specialist has ever included them in the conversations.
And I will add rheumatologists ultimately just monitor prescriptions.and endocrinologists actually study solutions.

If you Google it, you'll find US is being used more and more as a diagnostic tool for PMR. PMR is not straightforward to diagnose, as you and most of the rest of us well know.
For example, from Mayo:
Tests your doctor might recommend include:

"Imaging tests. Increasingly, ultrasound is being used to distinguish polymyalgia rheumatica from other conditions that cause similar symptoms. MRI can also identify other causes of shoulder pain, such as joint changes."

It is definitely being used more and more for diagnosis of PMR.

Thanks so much for bringing the use of US into my knowledge base. I wish the technology forums I use had participants as invested in expanding the common community good as much as this one! I'm going to be a little more careful about pronouncing my own experience into generalizations!
So is the UV able to discriminate between injury, PMR, other rheumatical conditions, and just plain old temporary stif and soreness from over doing it at some exercise or activity?
I am still able to participate in my favorite activity (surfing) and I still train with exercise and weights to maintain strength and flexability.
And I am convinced (at age 73) I can tell the difference between significant soreness / stiffness and a PMR flare.
But thank you. I went and used the AI app CoPilot to look up the uses of both US and the blood tests Sed Rates and C-reactive protein .... and it confirmed the info on UV of course, but I found I didn't even clearly understand how the blood tests are used.
Information is empowerment,
Thanks!

Are you taking steroids, Stevie?
From what I understand, the US can distinguish among the conditions you mentioned, but as you said in your first post, I am not a doc, only going by the literature. And as we with PMR all know, every day can be different depending on inflammation levels and who knows what else PMR is still a mystery.
How did you access Co-pilot? Looks like you need some kind of medical approval.
I'm glad you're doing well! That's the important thing.

I've bouncing between 8 and 6 mg of Presnosine for over a year. Been on Prednisone for a total of 3 years. The worst decision I made ( with the ok of my rheumatologist !) was a little over a couple of years ago, ... before I really understood
how dangerous the steroid was
... I asked if it would be OK if I increased the dose to 20mg during a trip for large wave surfing ... It was concern for both performance and safety.
But I was an idiot and my doctor was worse .... That two weeks over medicated, I believe really complicated the weaning process. Up until recently I was still in increasing/decreasing based on severity and length of flares. For the most part now, I have a "tool box" of practices, herbs, and strategies that for the most part minimize the flares. But I've yet to get below 5mg where I can get evaluated for how much of the cordisol encouraging practices have the body begining to make its own.
I have good days and bad days. But unlike previously where it seemed random, I can usually point to an over activity, diet failure, or stress as the source of the pain,.fatigue, or
depression..

@glinda47, It's not uncommon for a misdiagnosis of PMR. There are a lot of conditions with similar symptoms that mimic PMR.
--- Diseases that mimic polymyalgia rheumatica (PMR): https://www.medicalnewstoday.com/articles/diseases-that-mimic-polymyalgia-rheumatica

This is an easier read for how PMR is diagnosed.
--- Polymyalgia Rheumatica (PMR): Diagnosis and Treatment: https://creakyjoints.org/polymyalgia-rheumatica/polymyalgia-rheumatica-pmr-diagnosis-treatment/