2013 Volume 20 Issue 1 Pages 28-31
We report a patient with polymyalgia rheumatica referred to our hospital as unexplained musculoskeletal pain and diagnosed when the symptom was exacerbated during continuation of treatment. A male in his 60s had experienced cervix, shoulder, and upper arm pain after the onset of herpes zoster in breast back. Although the symptom was prolonged for 17 years, blood tests and imaging findings showed no obvious abnormalities causing the pain, and diagnosis of causative disease was undetermined. Satellite ganglion block, trigger-point injection, and drug therapy had gradually diminished the symptom, but half a year later the pain was exacerbated. At that time, upper-arm grasping pain appeared, and C-reactive protein and erythrocyte sedimentation rate increased. We considered polymyalgia rheumatica and prescribed steroid; all symptoms disappeared quickly. In a pain clinic, when treating prolonged musculoskeletal pain, continuous clinical observation and detailed physical examinations are needed in consideration of the possibility of various rheumatic diseases.
