Suspected RA

[Leepeelee]

Hi there,

I wondered if anybody could help or advise me ?

I am 50 years old male, I had some issues with my wrist before Christmas which I had a diagnosis of mild Carpal Tunnel syndrome and Osteoarthritis. I then suddenly developed severe pains symmetrical in both supper arms and shoulders followed by pains in both upper thighs and groin area and a fever which felt like flu.

My Gp sent me for ESR blood test which gave a result of 47. He the prescribed a daily dose of prednisolone . The preds immediately took effect and the symptoms disappeared.

The GP then sent me for another ESR blood test which gave a result of 22. He then diagnosed PMR. Polymyalgia Rheumatica, with a referral to a Rheumatologist.

I went to see the Rheumatologist yesterday, he thinks that it is unlikely that I have PMR as I am to young for that, more likely to be RA and so has sent me for more blood tests along with X-rays, ultra sound and urine sample. He has asked me to reduce the preds rapidly from 20mg down to 10 mg over the next 4 weeks with a follow up appointment booked when he will then have viewed my results etc.....

Are the symptoms from RA that similar to those of PMR??

[JFlay]

Hi, a lot of symptoms do tend to overlap from one condition to another. Here's some info from NRAS:

nras.org.uk/making-a-diagno...

It's good that you are having all the tests etc. and I wish you well 👍

[Chrisellie in reply to JFlay]

The paper info is wrong in that PMR is generally in people over 65. Over 50 is normal and sometimes earlier. I was 61 and many on the PMRGCAuk section of healthunlocked are around 50 Even the NICE document about PMR 2020 shows this,albeit further down the reading.

[JFlay in reply to Chrisellie]

Maybe NRAS should update it.

[cass24]

I'm very new to this "game" myself but yes from what I can understand, many of the symptoms are very similar and I was initially suspected of having PMR myself (like you I suspect, largely due to my age... though I've since discovered that's a bit of a myth anyway as it's perfectly possible for people to get PMR in their 50's and even earlier).

Unfortunately when I went to see the rheumy, he immediately said he thought it was more likely to be RA, as far as I could tell, due to examining the way my joints were affected and no doubt down to his experience too. I didn't want to believe it at first (at least PMR is, or can be, "self limiting") but subsequent blood tests showed a positive anti-CCP level which I understand is strongly indicative of RA, despite still not (at least so far) having a positive Rheumatoid Factor (RF)...

Again, from what I understand, one of the distinguishing factors of PMR is that steroids are about the only thing it responds to (and usually quite quickly if at the right dose), so if it's worked so far, a fast taper may well cause you to "flare" again... Then again, steroids can also give good (temporary) relief from the symptoms of RA too... so your reaction to tapering may not necessarily be "proof" either way...

You may have found it already but there's a very good PMR support forum on here too, but your rheumy will probably be the only one to tell you for sure.

Hope this is at least some help from my own experience and understanding... and good luck on your journey where ever it leads....

[GranAmie]

Hi there; i developed PMR [their 'best guess' said the neurologist] in 1999. Pred 40mg!! worked immediately - hyped up 'won' uni challenge [tv] etc . Very gradual tapering brought me down over about 11 years. Then in 2015 RA appeared; a whole new ball game. PMR was mainly shoulders and thighs, morning stiffness, cdn't do squats, rise from chair, driving v difficult etc etc. Ra a v different effect apart from morning stiffness. Hands had been 'freezing' on steering wheel for several years but a number of stress events inc near death in 2014 in Canaries left me with hand arm shoulder pain on left side. Chiro daughter worked at me for abt 3 months then told me to get full blood test done...May 2015: hello RA :(. GP gave me statins then [even tho bp, cholesterol etc v v good. Result - total collapse,temp., vomit, ankles agony , ambulance to A&E. Admitted ? food poisoning??. where ward medic said 'home in 2 days... anything else?'. That was when i told him .. elephant feet, stabbing pains, cdn't walk at all. 1 look @ my feet 'hell, what's that?' I said maybe RA, but dunno. @What yr rheumy say?'..'not got 1, six+ month wait..'. Next day he'd organised a rheumy to see me.etc..

SORRY this soooo long but gabby granny here. And doing well NOW. xx

[GranAmie]

ps aged 58 when developed PMR [nowadays referred to as muscular arthritis !!], 72 when RA diagnosed -