This is a report of two patients, one having polymyalgia rheumatica (PMR) and another with giant cell arteritis (GCA). Both the patients had raised erythrocyte sedimentation rate (ESR) and C-reactive protein and were consuming high w-6/w-3 fatty acid ratio diet. Both responded to prednisolone. Low w-3 ratio diet or fish oil should be considered for prevention of recurrence.

Three patients are presented who sustained bilateral rupture of the Achilles tendon while on systemic steroid therapy for chest disease; a fourth patient with polymyalgia rheumatica on steroids is also presented. This is further evidence that tendon rupture can be a direct complication of steroid treatment. The English-language literature on bilateral Achilles tendon rupture is reviewed.

The diagnosis of polymyalgia rheumatica (PMR), characterized by proximal pain and stiffness, is often uncertain owing to PMR mimics, such as rheumatoid arthritis (RA), spondyloarthritides, inf lammatory myopathies connective tissue diseases and vasculitis – all of which can present with the polymyalgic syndrome in the elderly. Inflammatory markers are often discordant with disease activity and ...