@pmrsuzie I had x-rays and an MRI of my right shoulder. This was at the start of PMR. I was convinced I had an orthopedic problem. The tests showed that I had some osteoarthritis and small slap tear in my right shoulder. But he said for 70 yrs old , that was not my problem. Testing also showed some bursitis. He gave me cortisone-steroid shot and said that he would only do the one. His comment was the shots would eventually deteriorate the joint and tendons. He would do plasma injections at $500 shot. By then the PMR had moved everywhere else. All my joints were sore. 4 hours after my first prednisone I was a new man. To answer your question, they might be able to tell from an x-ray but I would say an MRI is better. Particularly as we age and try to be active it doesnt take much to tweak a muscle and those muscles take forever to get better.