Findings on physical examination in patients with Polymyalgia Rheumatica

What are the findings on physical examination in patients with Polymyalgia Rheumatica?

The patient’s physical findings are less striking than the history would suggest. Patients may appear chronically ill. The neck and shoulders are often tender, and active range of motion of the shoulder may be limited due to pain. With longer illness duration, capsular contracture of the shoulder (limiting passive motion) and muscle atrophy may occur. Joint movement increases the pain, which is often felt in the proximal extremities. Synovitis, if present, most frequently is found in the knees, wrists, and sternoclavicular joints. Muscle strength testing is often confounded by the presence of pain. However, the patient’s objective strength testing is normal unless disuse muscle atrophy has occurred.

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