Steroid Pseudorheumatism (Arthralgias and Myalgias Associated with Steroid Withdrawal)

 

NOTE: Other features of corticosteroid withdrawal are discussed in Chapter 13.

 

Clinical features:

(1) recent discontinuation of corticosteroid therapy, which may be short or long term

(2) onset of diffuse arthralgias, myalgias and tendon pain

(3) presence of joint and muscle tenderness

(4) may be associated with fatigue, memory deficits and irresponsibility

(5) no other condition can explain the findings better

(6) symptoms remit on restarting steroids, which can then be discontinued by slow taper

 

Differential diagnosis:

(1) rheumatoid arthritis

(2) fibromyalgia

 

The distinction from other conditions can often be made by an experienced physician after a complete history and physical.