Many many people were not diagnosed early enough in the course of their disease. I see them in the infusion room all the time. And their hands are frightening. But that’s not an unavoidable outcome. I rarely have swelling or enlarged joints in my hands and I've had RA for 12+ years. There is not a single presentation but I was put on Humira within days of my onset and i stay on top of it. I take Prednisone for every material flare and start tapering off on day 1. So joint deformation has never had a chance. There is not a single course of symptoms. And there is a wide range of treatments. But you have to be an active participant in the outcome.

When I tapered to about 7, I started having mild wrist/finger/thumb pains in the AM. The pain was usually gone by 1400, most probably due to morning prednisone taking effect. Wrist imaging showed a mild case of osteoarthritis, which is probably the cause. I am continuing to taper, now at 4.5, and still experiencing the same stiffness and pain levels, but less frequently.
My theory is that I had mild osteoarthritis before experiencing PMR, and it was not noticeable because my normal cortisol production was keeping it under control. As I continue to taper, I am experiencing (and will continue to do so) a cortisol production shortfall while my adrenals struggle to increase production, and I therefore expect that the stiffness and mild pains will continue and are to be expected on occasion as the taper continues.
The message here is that pain during taper while on low levels of prednisone is not necessarily PMR pain. Although increasing your dose of prednisone would probably eliminate the pain, that approach should probably be avoided without doc agreement.