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PMR can mimic many other conditions. Edward had symptoms which met the core inclusion criteria for PMR, but the following features should lead you to reconsider the diagnosis:
Given the deterioration in renal function, continued elevation in ESR and blood found on urine dipstick you decide to organise an urgent ultrasound scan. The scan reports:
"A large homogeneous solid mass with well-defined margins is visualised inferior to the liver. A normal right kidney is not identified."
These findings are most consistent with a renal tumour. You refer him to the urology suspected cancer clinic where he's diagnosed with a renal cell carcinoma and is started on treatment.