Are painful swollen hands and fingers a PMR flare?

Hmmm. they were all showing negative but that means you have no signs of inflammation. . Which you'd have to have to attribute your hand pain to PMR wouldn't you? And I'm not challenging you, i just don't know anything about PMR blood results.

The only thing i am sure of is that not showing positive for RA Factor does mot mean you don't have RA.

For the record, the pseudo- carpal tunnel is how my RA started. One hand one morning, both hands the next morning, I couldn't open my front door or a bottle of water by day 3, my shoulders and hips were on fire, my ankles wouldn't bend and i had so such weakness I had to put my shampoo bottle between my knees in the shower because my hands were too weak to squeeze it out. I took 5 mg of prednisone with no effect.
My Rheumy was fairly confident I had PMR but something told her it was RA and she put me on Humira
In her office. Within 5 days I was better.
So diagnosis of these maladies is a crap shoot. 😁. Hang In there.

Re blood tests for pmr. Generally sed rate and crp are elevated. RA and anti-CCP antibodies are negative.
I was also slightly anemic.
Originally I saw an ortho Dr for the hip pain who told me to see a rheumatologist, researched rheumatic diseases that matched my symptoms, asked PCP to order a battery of tests for pmr, PCP had sent me to the ortho Dr. I spent many years working in a hospital chemistry lab so I understood the testing. My pmr was crippling in the beginning but I was able to get a diagnosis within 2 weeks.

What battery of lab tests are there for PMR? There is no diagnostic lab test that I’m aware of. An IL-6 lab test might be useful.

Are you talking about imaging tests and ultrasound testing and things of that nature?

https://www.webmd.com/rheumatoid-arthritis/an-overview-of-rheumatic-diseases
This may have been the article that started me me on the path to a diagnosis. My biggest problem was the morning stiffness and pain that eased after moving around. Pmr seemed likely.
I understand there is no exactness in matching test results to a specific disease but you have to start somewhere. Symptoms and blood test results may/can lead to a probable diagnosis. Prednisone helped me immensely and quickly.
These discussions always end up using the terms: likely, probably, may, maybe, seems like, generally, could be.
No exact science

Prednisone helps whether PMR or RA. Morning stiffness that process over a couple of hours is also a hallmark symptom of RA.

Just saying. RA has other treatment options like biologics i would want to try before ruling out RA.

Here is the list of tests they ran on me. Mine were all normal except HS-CRP. Made convincing my Rhumy a little more difficult. He also ran a PET Scan.
1.. CBC with DIFF
2. ESR
3. CRP, HS-CRP **
4. HBsAG
5. Interferon Gamma, Serum
6. Hep -B
7. Anti-Chromatin Ab, IgC (RDL)
8. CCP Antibodies IgG/IgA
9. 14-3-3 eta Protein
10. Antiphospholipid Antibody APS, APLS
11.RF test
12. ANA - antinuclear antibody
13. Aldolase - With CK, ALT, AST
14. Interleukin 2 and 6

That’s a very thorough Rule-Out list!

I cant remember which one. I think the IL-2 medicare did not want to pay for. Everything else went through.

I just want to clarify that i’m not challenging you for the sake of it. I am hoping for you there’s a path to a diagnosis of RA rather than PMR. One - you avoid a lifetime of challenges associated with Prednisone. Two - there is a larger number of effective treatment paths with RA. And transitioning from one to another is fairly straightforward compared to stopping Prednisone.

I have some osteo. Almost all of us do. I don't have noticeable swelling in my hands. Other than symptoms that could be related to age and drugs, like fatigue and pain and weakness, if I wasn't positive for RA Factor you might be justified in questioning my diagnosis. But the week before my infusion of Remicade and the week after tells the story.

I wish you all the luck as you go forward!