Objective: Parkinson’s disease (PD) is a neurodegenerative disorder affecting the basal ganglia. Parkinsonism is the main syndrome of PD, characterised by bradykinesia, rigidity, rest tremor and postural instability.

Background: A 77 year old male was seen in the out-patient department with complaints of joint pain, especially in knees, progressive difficulty in movements, especially when getting up or lying down. The complaints were noted within the last 2 years. The history was significant only for arterial hypertension. The patient was treated by rheumatologists for polyarthritis with NSAIDs and steroids with minimal effect, hence the patient was referred to a neurologist.

Methods: Neurological examination revealed moderate vertical gaze paresis, cogwheel rigidity in all limbs, more prominent on the left, mild bradykinesia, hypomimia. Cognition was assessed by MMSE (the score was 24). The laboratory analyses were within normal range. Brain MRI showed no obvious focal lesions.

Results: The diagnosis of Parkinson’s disease was established and treatment with dopamine agonists was initiated with clinical improvement on follow-up.

Conclusions: Even though there are typical features for diagnosis of PD, in some cases the symptoms can be misunderstood, stressing the importance of multispecialist assessments.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-case-of-misdiagnosed-parkinsons-disease-pd/