Fibromyalgia vs polymyositis vs polymyalgia rheumatic

:'■ ■ (.'Us.<H' adult iemalcs 40-ott ;.t-ar o|tj wmiin ':"■: :<;< Women • So y,a>. old.;■

'l CUs-sic findings Anvii-ly, Mtvss, insoiuiiu, point ■ v;::: K^v.-m-d i 't!K. ,itjih.>iin,il I !vu; .md k mr.ot,.; ,imTiti\. grt.ii k •,)«>n<..:-;.:..v.

;■■ '■■:te&deriifesj?V l^pSK .greweM>>l lynu-f: ■ u> s£wi'ji4s,:.:Mty.hlglt ESR,:e}d(*j,ly:

.»am; w^^lfc-r.^tg^^^t^^fw^t^tf^iww^irai-rr mun ln'mi |Wim ihi.mikhi ,m.ii>|H Wi> ^ i.pnsn ■ l |Wiip«i^WMMWM»«lllihi .iiiihi lut^mumimm iliilh ^ l i^igw^^-wftjiifgr^vwr*.!!^

Paget's disease: a disease of bone in which bone is broken down and. regenerat ed , often simultaneously; seen in patients > 40 years oJd, more common in men. Often discovered in an asymptomatic patient through an x-ray; be able to recognize a Pagetoid skull (frontal bossing). Classic sites of involvement are in the. pelvis and skull. Watch for a person who has had to buy larger-size hats. Patients may complain of bone pain, osteoarthritis, nerve deafness, or paraplegia. Alkaline phosphatase is markedly elevated in the presence of normal calcium and phosphorus. The risk of osteosarcoma is increased in affected bones. Treat with NSAIDs, possibly etidronate or calcitonin for severe disease.

Note: With juvenile RA, rheumatoid factor is often negative. Watch for uveitis (especially in pauci articular form).

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