Rheumatoid Arthritis Support Group
Rheumatoid arthritis is a chronic, inflammatory, multisystem, autoimmune disorder. It is a disabling and painful condition which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and...
I was just wondering if anyone else had been diagnoised with PMR (Polymyalgia Rheumatica) and then been told it has possibly moved into Rheumatoid Arthritis. It's been four months since I was diagnoised with PMR by my Rheumatologist on November 24, 2014.
To recap: I had all the classic symptoms of PMR the end of September, 2014 with severe shoulder pain and stiffness, couldn't raise my arms over my head, took two hands to hold a cup of tea, severe pain and stiffness in the backs of my legs and thighs to the point I couldn't sit, could barely walk at times or get up from a sitting position, or out of bed, etc. and the only thing that helped was prednisone. Gabapentin, Tramadol, Lyrica, and naproxen were all tried and nothing but prednisone worked. I went through tons of lab work, blood work, x-rays, etc. that all came back OK with the exception of high muscle enzymes. Worked with my internist who took me off Statin drugs (Zetia and Zocor), saw a neurologist, and finally referred to a rheumatologist in November 2014 which resulted in the diagnosis of PMR on November 24th. I was put on four infusions of prednisone, 250 mg. each time, in early December, and started 15 mg. prednisone daily, 7&1/2 mg, of methotrexate once a week, plus folic acid 1 mg daily, and Actonel 150 mg once a month. Methotrexate has been increased along the way and prednisone decreased. I'm currently at 12&1/2 mg. of prednisone daily and 20 mg. of methotrexate once a week and doing well at the moment with the pain and stiffness gone for now and only dealing with the fatigue and occasional cramping of hands after repetitive movements.
At my check up on Mar.18th with the Rheumatologist told me that she thought due to the lab work, etc. in late February and the flare up I had in February she felt that I was really leaning more to Rheumatoid Arthritis than PMR. I see her again in two months when they will do more blood work. I just wondered if this had happened to anyone else here. Any information about the differences in the two, PMR vs. RA, deciding factors for diagnosis, etc. will be greatly appreciated. I know nothing about RA and was just starting to somewhat understand PMR. I was tested for RA in the early testing last October, but no positive results at that time.
Thanks for you help and input!!!
To recap: I had all the classic symptoms of PMR the end of September, 2014 with severe shoulder pain and stiffness, couldn't raise my arms over my head, took two hands to hold a cup of tea, severe pain and stiffness in the backs of my legs and thighs to the point I couldn't sit, could barely walk at times or get up from a sitting position, or out of bed, etc. and the only thing that helped was prednisone. Gabapentin, Tramadol, Lyrica, and naproxen were all tried and nothing but prednisone worked. I went through tons of lab work, blood work, x-rays, etc. that all came back OK with the exception of high muscle enzymes. Worked with my internist who took me off Statin drugs (Zetia and Zocor), saw a neurologist, and finally referred to a rheumatologist in November 2014 which resulted in the diagnosis of PMR on November 24th. I was put on four infusions of prednisone, 250 mg. each time, in early December, and started 15 mg. prednisone daily, 7&1/2 mg, of methotrexate once a week, plus folic acid 1 mg daily, and Actonel 150 mg once a month. Methotrexate has been increased along the way and prednisone decreased. I'm currently at 12&1/2 mg. of prednisone daily and 20 mg. of methotrexate once a week and doing well at the moment with the pain and stiffness gone for now and only dealing with the fatigue and occasional cramping of hands after repetitive movements.
At my check up on Mar.18th with the Rheumatologist told me that she thought due to the lab work, etc. in late February and the flare up I had in February she felt that I was really leaning more to Rheumatoid Arthritis than PMR. I see her again in two months when they will do more blood work. I just wondered if this had happened to anyone else here. Any information about the differences in the two, PMR vs. RA, deciding factors for diagnosis, etc. will be greatly appreciated. I know nothing about RA and was just starting to somewhat understand PMR. I was tested for RA in the early testing last October, but no positive results at that time.
Thanks for you help and input!!!
Have you had any kind of rash with it? If not, scratch the dermomyositis.
RA doesn't typically involve elevated CK. that's why I wondered. But, maybe PMR does. My doc thought I had PMR even though my anti-ccp was already >250 plus high Rheumatoid Factor. My symptoms were episodic for years...but I for sure have RA.
Regardless, sounds like your treatment is right.
I was started on on MTX immediately and later added one and then an other biologic (currently Orencia). A year later I am much better but still fighting it, have only a few, fairly minor flares of short duration occasionally, and have reduced the prednisone to 6mg. I hope to go off it entirely in the next 3 to 4 months.
The important thing is that you get your Ra under control ASAP. The better you control your Ra during the first 5 years, the better the long term outcome. Even better if you can get it under control in the first year. Glad your doc is on top of this.
gentle hugs..........jen
It's easy to see where the lines between these diseases can be blurred. IMO one can open the door for the other, or can a patient have both? I'm sure it's not unheard of.
With very similar symptoms of so many it can be mind boggling.
Then throw in the possibility of RA negative blood work.
I'm RA positive but am botherered by large & small joints both a like. Shoulders can be a bugger. Yet with cervical & Fibro thrown in who knows.
Appears to be anything is possible with type of disease.
Even with all the testing I believe there can be a lot of pain & wondering before the damage appears on any test. Sadly enough.
I think Sally is right as far as doctors lagging behind with proper testing. Yet I also feel palpating the joints & body can help give the doctor insight. It's to bad we are left with so many questions even when we have medical care.
We learn just how important it is to be our own advocates.
Perhaps keeping notes, journal of sorts on how you feel, changes & even any questions.
Thank god for groups like this. No we are not doctors but more often then not we learn something.
The more I read the more apparent it becomes how much we need to keep clear communication with our doctors & pray we are in good hands.
Sammy