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PMR vs. sero-negative RA

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SectionedThrice
SectionedThrice

I had posted earlier about this group's experience with Plaquenil.  During that same discussion with my Rheumatologist, he wondered aloud whether I might have sero-negative RA rather than PMR.  I'm not sure I understand the differences between the 2, other than that PMR will (hopefully) burn itself out.  It's almost 4 years and I'm still waiting!

0 likes, 3 replies

3 Replies

  • EileenH
    EileenH SectionedThrice

    Posted

    A lot of them start to wonder that when the patient still has symptoms after more than 2 years as they have this idea PMR only lasts 2 years! Rather than the median of 5.9 years that is the case.

    RA is an arthritis - and it eventually affects the joints. PMR is a vasculitis and DOESN'T damage the joints. In the early stages they CAN appear very similar - and there are other inflammatory arthritides which can present with a polymyalgia. There are no real definitive clues either way - although the anti-CCP blood test being positive is much more likely in RA than in PMR. Rheumatoid factor is very neither/nor - healthy people can be positive, people with RA negative. The answer comes when joint damage is obvious on imaging - and the hope of early use of DMARDs is to avoid that. The trouble tends to be that PMR can be accompanied by synovitis - making joints painful but it is different.

    I think they do often get confused - and I also suspect that the patients who do well with DMARDs (plaquenil, methotrexate, leflunomide) possibly didn't have PMR but LORA (late onset RA). 

    • ClaireJG
      ClaireJG EileenH

      Posted

      I think this is one of the most comprehensive and helpful accounts of the differences between the two conditions that I've heard. Thank you Eileen! 

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