Polymyalgia Rheumatica and Rheumatoid Arthritis

Question

My father has been diagnosed with polymyalgia rheumatica but now is having joint pain in his fingers? Could he have RA?

Answer

Polymyalgia rheumatica (PMR) is an inflammatory conditions that occurrs only in individuals over the age of 50 years. It is treated with low dose prednsione (20mg or less) and typically improves dramatically. Unfortunately, we do not have a ‘diagnostic test’ for PMR and the diagnosis is based on clinical assessment and response to prednsione. PMR can present with arthritis as a primary component but this should improve with treatment. Approximately 20% of patients with PMR are ultimately diagnosed with RA (because they can look so similar early in the disease course). If your father is still having joint symptoms than an additional cause for these symptoms (either inflammatory / RA or osteoarthritis) should be investigated and referral to a Rheumatologist is appropriate.

Rebecca Manno, MD, MHS

About Rebecca Manno, MD, MHS

Assistant Professor of Medicine
Johns Hopkins University