J Rheum Dis 2018; 25(2): 140-143  
Case of Polymyalgia Rheumatica Misdiagnosed as Infectious Spondylitis
Kee Eon Yoo1, Seoung Wan Nam1,2, Hyuk Hee Kwon1,2, Seunghun Lee3, Jae-Bum Jun1,2, Yoon-Kyoung Sung1,2, Soo-Kyung Cho1,2
1Department of Internal Medicine, Hanyang University Seoul Hospital, 2Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 3Department of Radiology, Hanyang University College of Medicine, Seoul, Korea
Correspondence to: Soo-Kyung Cho http://orcid.org/0000-0003-4493-8837
Department of Internal Medicine, Hanyang University Seoul Hospital, Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. E-mail:skchomd@hanyang.ac.kr
Received: May 27, 2017; Revised: October 13, 2017; Accepted: October 16, 2017; Published online: April 1, 2018.
© Korean College of Rheumatology. All rights reserved.

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Abstract
A 60-year-old woman visited the authors’ clinic with low back pain and arthralgia. Her symptoms had occurred 6 months previously, and she was treated with an epidural injection and a balloon dilatation procedure based on the assumption of spinal stenosis, but both treatments were ineffective. Her low back pain was aggravated, accompanied by fever and chills over a period of 4 months. As a result, she visited another referral hospital and was diagnosed with infective spondylitis associated with the invasive procedure. Her symptoms improved with antibiotics, but they recurred. When she visited our clinic, she still had continuous low back pain and febrile senses. Magnetic resonance imaging of her lumbar spine revealed interspinous bursitis, and 18 F-fluorodeoxyglucose positron emission tomography showed multifocal synovial inflammation. She was diagnosed with polymyalgia rheumatica and treatment was started on prednisolone and celecoxib. Her symptoms improved dramatically and the inflammatory markers normalized.
Keywords: Polymyalgia rheumatica, Back pain, Arthralgia, Positron emission tomography computed tomography


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