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Rheumatologist has now diagnosed me with Rheumatoid Arthritis
My rheumatologist has now diagnosed me with Rheumatoid Arthritis due to extremely painful wrists beginning in April of this year. I was diagnosed with PMR in April of last year (2024) and have been on & off Prednisone (tapering). In April this year (2025), he had me back on 15 mg Prednisone (tapering again), 10 mg Methotrexate, and 10 mg Leflunomide. After one month of Leflunomide, my liver blood tests went up. I am now off Methotrexate and Leflunomide, and tapering off Prednisone. My question is has anyone else been diagnosed with Rheumatoid Arthritis after a bout of PMR? I don't know if I have both PMR and rheumatoid arthritis right now. Doc will check my blood tests again in a few weeks and probably prescribe another medication. Has anyone else experienced this? thank you
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I was diagnosed with PMR, and then 3 months later, I was diagnosed with RA. Pain in my wrists. Couldn't even pump gas in my car, because I couldn't squeeze the the the handle. Took the Methotrexate and that took care of it. Now working on my Prednisone taper.
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1 ReactionWhen I first saw my PCP for my joint pain/stiffness two years ago, they thought it may be RA and started me on methotrexate. The pain and stiffness kept getting worse to the point I was basically bed ridden. So they thought it was more likely PMR and started me on 20mg prednisone and discontinued the methotrexate. Within 4 hours I started feeling much better and by the next day was up and about. When I finally was able to see a rheumatologist 4 months later, she insisted that PMR shouldn't affect the smaller joints, but she has finally come around to the fact that PMR affects people differently with different treatment per individual (i.e.. splitting pred doses in AM and PM) and we do not all "fit neatly in a box". When I have small flareups or typical minor morning stiffness/pain, it does affect my wrists and I feel it is part of my PMR. Tylenol Arthritis makes a big difference for those days when I have wrist pain in the 2-3/10 range and really helps when I take before playing golf. Whenever the pain gets above 3/10, it is usually accompanied by elbow and shoulder pain and a sign of a more mid-level flare that I knock out with a day or two of an additional 5mg of pred in the morning.
Goof Luck!
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3 ReactionsI had an identical experience. Diagnosed with PMR in January 2024, and had only a minimal reaction to prednisone. My dose kept getting increased until it hit 40 mg, which finally seemed to help. However my sed rate had occasional spikes. Six months later, after complaining of hand and wrist pain, I was started on methotrexate. I’ve been able to taper down on the pred to my current dose of 3 mg. My RA factor was negative, but several other more sensitive lab tests were positive for inflammatory arthritis, and I’ve been told it is mot likely RA.
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2 ReactionsWe know there is significant overlap between PMR and RA symptoms. In fact I believe when you likely have both, they call it “overlap syndrome”. I think we need Dr. House!
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1 ReactionIf it is RA there are more treatment options available. It is unlikely that you will be left on long term prednisone for years without being offered some alternatives.
There are some specific tests for RA. It isn't like diagnosing PMR when they say, "We don't know what it is so PMR is their guess"
There are other types of inflammatory arthritis. I have a type of inflammatory arthritis that isn't RA. My type is abbreviated ReA for Reactive Arthritis. My type of inflamamatory arthritis mostly attacks my spine. When it has nothing better to do it will attack other joints both large and small.
https://www.mayoclinic.org/diseases-conditions/reactive-arthritis/symptoms-causes/syc-20354838
My type of inflammatory arthritis was diagnosed when I was in my early 30's. When I was old enough, the diagnosis of PMR was added to my list of autoimmune problems. I think there should be a rule that you can only have one autoimmune condition. My rheumatologist said there wasn't any rule that you can only have one autoimmune condition.
https://www.autoimmuneinstitute.org/articles/comorbidities-in-autoimmune-disease-multiple-autoimmune-syndrome/
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PMR and GCA are "associated" with each other with "overlapping" symptoms. Now they are considered to exist on a spectrum.
https://pubmed.ncbi.nlm.nih.gov/27481272/
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If you ask me ... all autoimmune conditions exist on a spectrum of autoimmune conditions. Maybe that would distribute the research so all autoimmune conditions receive equal treatment.
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1 ReactionVery good! I agree one size does not fit all. And I think finally these physicians are stating to think instead of following protocols. Not that all protocol treatments don’t work but they don’t work for everyone. If doctors listened more carefully and conferred with their colleagues that might work better. I too have some success with arthritis Tylenol. And I treat flares differently too. I am learning more how to manage this condition. My doc is great and works with me and gives me options to research. This site has helped a great deal too to see what you all are dealing with and finding. Thank you.