Causes of 3 figure ESR

Friday, July 8, 2011


I was taught by my prof that there are 5 common causes of a 3 figure ESR:

1) Multiple Myeloma
2) Polymyalgia Rheumatica/Temporal Arteritis
3) SLE
4) TB
5) Advance Malignancy

Though these are common causes, they are not definite or exhaustive. I have actually came across a lady with rhrumatoid arthritis having an ESR of 120mm/hr.

This gentleman presented with 1 year history of chronic back pain that worsened over the past 4 months. His condition deteriorated 2 weeks prior to admission and he was unable to ambulate independently without the aid of crutches due to the pain. Multiple X-rays were taken and showed
His ESR was 114mm/hr. What's the diagnosis?