A 76-year-old woman shows symptoms including severe stiffness and vision loss. What condition is most likely?

The symptoms presented in this scenario—severe stiffness and vision loss—are indicative of polymyalgia rheumatica (PMR), a condition commonly affecting older adults, particularly those over the age of 50. PMR is characterized by bilateral pain and stiffness in the shoulder and hip girdles, which tends to be worse in the morning and improves with activity throughout the day.

Vision loss in this case raises the suspicion of associated giant cell arteritis (GCA), which can occur in conjunction with PMR. GCA is an inflammatory condition that affects the blood vessels, particularly those around the head, and can lead to vision loss if not treated promptly. The fact that the patient is 76 years old aligns with the demographic most commonly affected by PMR and GCA, making it a plausible consideration.

Rheumatoid arthritis is characterized by symmetrical joint pain and morning stiffness but does not typically cause significant vision loss. Degenerative joint disease primarily presents with joint pain and stiffness but tends not to be associated with systemic symptoms such as vision changes. Fibromyalgia presents with widespread musculoskeletal pain and fatigue; while it can cause stiffness, it does not typically lead to vision loss.

Given the age of the patient and the combination of symptoms, PMR