Surprised and Uncertain: Should I get a second opinion?

Posted by glinda47 @glinda47, May 7, 2024

After several months of pain and over a month waiting for an ultrasound, my doc says she sees little to no inflammation on the US and does not feel my diagnosis is PMR. I asked about the bi-lateral pain and she said possibly bursitis or tendonitis. She said to exercise. PT is OK. She did see some minor injury to right rotator cuff which I knew I had. I can't understand this. I should be very happy but I wonder what might be lurking underneath? Cancer? Vasculitis? I want to be happy but don't really know what do think.

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

@jj8431

Hi John, you are correct, it is not uncommon to misdiagnose PMR. This is my story... I have documented it elsewhere in this sea of comments under PMR. I am going to copy and paste it again just so others are aware, then I plan to sign off this website, because it no longer applies to me. It has been very educational and helpful to me in trying to understand the multitude of auto-immune diseases.
You can delete this comment or move it to the appropriate discussion. Thanks for allowing me to post.
Btw, supposedly, I remain in remission but still continue to require surgical treatment to repair bone destruction caused by bone marrow disease.

jj8431 | @jj8431 | Jan 5 8:42am
I would like people to know that the diagnosis could be something other than PMR. I have been living my nightmare for 2 years now. Mine started with the classic textbook symptoms for PMR, bilateral joint pain, first the hips (couldn't even roll in bed or get out of a chair) then progressed to the shoulders, then to other joints. I responded to prednisone like a miracle. My local Rheumy eventually tried to wean the prednisone and added methotrexate when my bilat shoulder MRI's ( I had developed bilat "lumps" on the clavicle bones) showed questionable Rheumatoid Arthritis, amongst multiple other possible diagnoses. I also had developed Prednisone Induce Diabetes and weight gain; I started oral hypoglycemics. I was sent to an Orthopedist, for my shoulder pain, he wanted to do bilateral shoulder replacements! I said, no thanks, not until somebody figured out what was wrong with me. ( This is the same doc who said I needed a total knee replacement, just 2 months before my PMR diagnosis. I always will wonder if I really needed that surgery). I went to a different Orthopedist who said I did not need shoulder replacements, I needed biopsies! Shortly after being on the prednisone, I developed these strange skin lesions, purpura, in of all places, the crotch. It was felt to be a side effect of the prednisone. Finally, I went to a Dermatologist who biopsied those skin lesions. Diagnosis came back as Amyloidosis. I immediately made an appointment with a specialist at the Cleveland Clinic, 2 hours away. He did multiple studies and found that I also had Multiple Myeloma, a Cancer! of the plasma cells within the bone marrow, causing bone pain. The Amyloidosis is similar, however, not a cancer, but also a disease of the protein cells of the bone marrow where abnormal protein cells deposit into multiple organs rendering them non-functional. Mine happened to be in the skin, and no major organs, that we can tell. My Rheumatologist at the Cleveland Clinic doubts I had PMR and feels that my Amyloidosis had deposited into the joints, causing all the pain, she finally got me off the prednisone. I went on to have 4 months of chemo followed by a Stem Cell Transplant a couple months ago. I developed complications during this treatment, was in ICU and subsequently developed kidney failure, stage 3.
So, I guess my message is, please seek out other professional opinions, don't hold back, even if they think you are nuts. It could be something other than PMR and hopefully, eventually, they will find what is causing all your symptoms, especially if your current treatment is not working or you continue to develop other issues as the folks above have experienced. Thanks for listening.

Good bye and God bless.....

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Thank you for sharing your story again. It is really helpful for others to learn that they are their own best advocates when it comes to finding an answer to difficult health conditions. I hope you decide to stay with the Connect community. It's really helpful when others are struggling and are able to read different experiences. Hoping you have a blessed 2025.

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I got a huge runaround from PCP and rheumatologist and orthopedist because I didn't have the blood markers for PMR but there was no other explanation for what I had. Finally I got my PCP to agree that I had PMR and I began titrating up with prednisone from 1 mg over 3 months to 8. I'm now titrating down. There's so much good information from PMR specialists that I don't understand why rheumatologists are hesitant to diagnose it.

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@jillkellyauthor

I got a huge runaround from PCP and rheumatologist and orthopedist because I didn't have the blood markers for PMR but there was no other explanation for what I had. Finally I got my PCP to agree that I had PMR and I began titrating up with prednisone from 1 mg over 3 months to 8. I'm now titrating down. There's so much good information from PMR specialists that I don't understand why rheumatologists are hesitant to diagnose it.

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I think that they are hesitant because they know very little about the disease. The only treatment for PMR since it was diagnosed in 1957 is prednisone. No cure, No idea what causes it. Like many auto immunes it can vary by patient and treatment. They have data on prednisone and in this case the treatment has as many side effects as the disease. I believe they are reluctant to prescribe prednisone as the treatment knowing that treatment can last for years.

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@jillkellyauthor

I got a huge runaround from PCP and rheumatologist and orthopedist because I didn't have the blood markers for PMR but there was no other explanation for what I had. Finally I got my PCP to agree that I had PMR and I began titrating up with prednisone from 1 mg over 3 months to 8. I'm now titrating down. There's so much good information from PMR specialists that I don't understand why rheumatologists are hesitant to diagnose it.

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I agree. I think they are trying to correlate the data as to why this condition seems to have developed (suspicious of the Covid shot) because it’s not related to injury or trauma or lifestyle. 🤔 myself— mine is directly linked to Covid 19 shot.

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Research is showing that the base of vaccines (called adjuvants) seem to spark PMR (whether flu, Covid, shingles, pneumonia). They don't know why.

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I also had an ultrasound recently, in an effort to pin down my diagnosis. Both synovitis and synotendonitis showed up in my shoulders (which are usually found with PMR), as well as bone erosions (which do not occur with PMR but do with RA). I also have some labs which support inflammatory arthritis. So now my rheumatologist feels I have seronegative RA, probably in addition to PMR. I think both bursitis and tendonitis should have shown up on your ultrasound. Since it is not widely used as a diagnostic tool, I wonder if your doctor has a lot of experience interpreting ultrasound results, or whether a technician did.

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My Mom had this condition.
Is a biopsy no longer used to determine cause?
She had PR plus Giant Cell Arteritis.
She was put on massive amounts of steroids. Was able to work during this process and had a full recovery.

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