QD Clinic - Normal ESR PMR Save Feb 01, 2019 1:41 pm Rheumatologists’ Comments Jack, Fear not. I have seen 4 or 5 of these- all male (xc 1 older female), younger, better Px as you indicate. However, most of them seem to be preceded by intense physical activity- my 1st one could accurately date it to cutting down trees after a hurricane, another to rough-housing with his grandchildren and several others- all very atypical intense activity. I wondered if muscle injury could expose "hidden" antigens. All had sx's lasting months by the time I saw them w PMR-like response to low dose steroids and all off in 6-12 months. Gary Reply dear dr. some problems may be encountered in this situation. first ,this only rely on symptoms that may be confused with fibromyalgia or somatization disorders. second, while ESR is normal ,which test should be used to diagnosis Reply If you are a health practitioner, you may Login/Register to comment.Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.