08-15-2008, 11:57 AM
A 24-year-old woman comes to the physician because of constant, severe pain in her neck, shoulders, and back for 3 months. She has been unable to enjoy her usual activities because of the pain. Use of over-the-counter ibuprofen and aspirin has not relieved her symptoms. She has a history of irritable bowel syndrome. Examination shows multiple tender spots over the neck, shoulders, and lumbar spine. Range of motion of all joints is full. There is no evidence of synovitis. Fluorescent serum antinuclear antibody and rheumatoid factor assays are negative. Which of the following is the most likely diagnosis?
A
) Ankylosing spondylitis
B
) Fibromyalgia
C
) Polymyalgia rheumatica
D
) Polymyositis
E
) Seronegative rheumatoid arthritis
A
) Ankylosing spondylitis
B
) Fibromyalgia
C
) Polymyalgia rheumatica
D
) Polymyositis
E
) Seronegative rheumatoid arthritis