Rheumatologist says I do not have PMR: not a muscle disease but due to bursitis or synovitis!?

Posted , 10 users are following.

So I went to a new rheumatologist yesterday as my GP will not continue to treat me with pred. after the first rheumatologist said that I do not have PMR with normal blood tests, so I should be taken off the pred. that the GP put me on. The new rheumatologist said the same as the first one:I need to taper off pred. and get sick again, as they do not believe it is PMR when I have/had clean blood tests, and no signs of bursitis or synovitis in my joints (I had a PET-scan a year ago). I pointed out that PMR is the muscles, and he then said that it was an old fashion view, and that the word "polymyalgy" was misleading . PMR is NOT vascular either (also old fashion) - it is in the joints!! That is the new orange. This is apparently the consensus here in Denmark, so without elevated inflammatory markers OR synovitis there are no objective parameters to support the PMR diagnosis.

He also pointed out that PMR will NEVER give muscle atrophy even when left untreated for a long time - nor muscle twitches, so I should go back to the neurologists. I am speechless..... Has anyone heard of this before?

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  • Posted

    I don't know what to tell you. There are several people on this and other site dedicated to PMR who had also problem with diagnosis because they had "normal" blood test. 20% of PMR patients never have increased inflammation markers. Synovitis is sometimes add-on to PMR, but not always. As far as "PMR will NEVER give muscle atrophy even when left untreated for a long time", that is complete nonsense. If you cannot use your muscle due to pain ( or any other reason, say you are immobilized in a bed), you will have muscle atrophy.

    If I were you I would look for more experience, older rheumatologist, who has actually seen and treated PMR to diagnose you properly.

  • Posted

    I am sorry to hear about your dilemma.

    I've been dealing with PMR for about 6 years. In the beginning, no-one knew why I was hurting. My GP didn't know. They sent me to a Rheumatologist, who was worthless. They sent me to a muscular-skeletal specialist -- he didn't know. Then, one day I read a news article about a woman with symptoms just like mine -- who said she was diagnosed with PMR, who after taking prednisone had her symptoms disappear within hours! I took the news article to my GP, who agreed to treat me with prednisone -- and my symptoms disappeared within hours. I've been on prednisone ever since.

    In the beginning, My GP had me on an aggressively decreasing dosage pf prednisone-- and I flared up immediately. That's when I found this forum and learned about the dead-slow tapering method. I printed out what I learned on this forum and took it to my GP -- who said it was worth trying. I've been on it ever since. I got down to 0.5 MG but had a bad flare upon injuring my shoulder. I had to go back up to 5.0 MG but and back down to 2.5 MG again (and still decreasing).

    My GP started getting on my back to stop taking prednisone, since I was "beyond the 2 year life of PMR." Well, I knew better than "a 2-year life" from this forum. So I printed out what I had learned and showed it to him. He backed off immediately.

    Then I learned, from this forum, that long-term low dosages of prednisone ARE NOT HARMFUL (except for increased likelihood of cataracts). I printed out this information and sent it to my GP. He actually said something like "well then at your low doses I suppose that quality of life trumps any downside effects, so I'm with you."

    Bottom-line: I developed a working partnership with my GP, treating him as a professional who had to deal with all kinds of patients but who had little time to dig into any ONE particular, strange illness. I took my disease into my own hands, and tried my best to educate my doctor so that he could help other people better than I was initially helped.So far, so good.

    • Posted

      Thanks - I will actually try this. I will have to get an appointment soon with my GP so fingers crossed. If it was not for this forum I would go mad! If they want to start over diagnosing for other things, they can do that while I´m on pred, 😉

  • Posted

    I despair when I hear the limited knowledge of some of the medical profession. It is the fact that they are so wrong in their knowledge which is really frightening. I imagine they must be treating people with other illnesses the same way. Aghhh.

  • Posted

    Krillemy, I sorry that you have met several doctors with the GOD complex!🤔

    • Posted

      Yes some of them do feel close to God - and neurologist are even closer to God as we say here 😃 LOL

  • Posted

    Strange chap - PMR includes bursitis and synovitis. Is he sure he's thinking of the right disease?

    • Posted

      No - forget that - PMR does include both but I'm not sure it is essential for diagnosis.

      What did they find in the PET scan? Anything?

    • Posted

      I had the PET scan 10 months ago. That was 1 month after I stated to have acute bad pain. It was clean - nothing. It seems to be the Rheumatologist opinion that it is then not PMR as I it would have shown bursitis and synovitis. The one I just meet, he said that the PMR pain is coming from bursitis and synovitis, so with the original PET scan, I probably do not have PMR?

    • Posted

      But bursitis and synovitis ARE part of PMR - that doesn't make sense.

      I have spoken to a respected PMR/GCA rheumy in the UK who said:

      "We sometimes do get PET scans which don’t show anything. I think the jury is still out on what that means. In fact, more generally, I think people are still too dogmatic about PMR."

      Funny - been saying that for a while!!

      I have some reading from her - wlll get back to you. And have the name of a rheumy in Denmark perhaps.

    • Posted

      Thanks, but what is meant by "too dogmatic about PMR" ? I guess that a clean PET scan and no raised inflammatory markers is why they are questioning my diagnosis. A good rheumy in DK would be great. They will not even listen to the symptoms.

    • Posted

      That they have very fixed ideas about what PMR is and how it should present. It is a very heterogenous illness and there is no fixed pattern. It may be something else - but frankly, if a moderate dose of pred deals with the symptoms, that is as good as anywhere to start.

    • Posted

      Yes you are right - and I can take pred. while they check again for all the neurological diseases again....

    • Posted

      From the other tread I understand that itching and heart palpitations can be symptoms of PMR??? I have had both and I thought that is was due to something else. Like Lyme disease or MS that they also will check again. T

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