Questioning PMR diagnosis

Posted by jmarz @jmarz, Nov 8, 2022

I am 68, have been very active all my life, am T2 diabetic, experienced severe cramping in right hand in mid-August that was diagnosed by Orthopedic as carpel tunnel who gave me a steroid injection just before a long overseas trip. During that 25-day trip my right hand was severely swollen and right should had sharp pain.

I took Naproxen and Tylenol daily until returning to US, when the pain and stiffness migrated to both hands and arms/shoulders.

Rheumatologist diagnosed PMR after blood work showed extremely elevated SED rate and CRP, prescribed 15 mg Prednisone. While symptoms are better after 5 weeks, am struggling to keep blood glucose levels down while continuing to have flareups of hand and shoulder stiffness and pain. I also have symptoms that don't seem to line up with PMR including constant urination and a fruity breath, worried there is something besides PRM. I welcome other's experiences and appreciate reading what is posted.

Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.

Hello @jmarz, Welcome to Connect. You mentioned that you have Type 2 Diabetes and that you have symptoms that don't line up with PMR - constant urination and a fruity breath. I've read that these symptoms are related to diabetic ketoacidosis and is a serious complication of diabetes. Mayo Clinic has more information on the topic here - https://www.mayoclinic.org/diseases-conditions/diabetic-ketoacidosis/symptoms-causes/syc-20371551.

Have you discussed the symptoms with your doctor and your rheumatologist?

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I read same about ketoacidosis, also experienced extreme weight loss of 20 lbs over 45 days during and after my overseas travel, told PCP and Rheumatologist who both dismissed those symptoms. Have wondered if I need to find Endocrinologist.

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FYI weight loss on travel may have been driven by my burning 1000-1500 cals/day over set point according to my Apple Watch tracker, weight has stabilized/gained 4-5 lbs back in past 2 weeks.

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@jmarz, You might want to take a look at these two PMR discussions to see if anything lines up with your symptoms?

-- Do I really have PMR?:
https://connect.mayoclinic.org/discussion/so-i-really-have-pmr/
-- PMR initial diagnosis: Can there be an underlying disease?
https://connect.mayoclinic.org/discussion/pmr-initial-diagnosis-1/

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