Rheumatoid Arthritis vs Polymyalgia Rheumatica
Rheumatoid Arthritis and Polymyalgia Rheumatica are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Rheumatoid Arthritis vs Polymyalgia Rheumatica at a glance
- Rheumatoid Arthritis: Chronic symmetric inflammatory polyarthritis with autoantibodies and erosive joint damage.
- Polymyalgia Rheumatica: Inflammatory syndrome of shoulder and hip girdle stiffness in adults over 50; dramatic response to low-dose steroids.
Keep comparing — start your free trial
You've used your 2 free previews. Create your free account to see the full Rheumatoid Arthritis vs Polymyalgia Rheumatica comparison — plus all 514 diagnosis outlines, 6,400+ board-style questions, and an AI tutor. Your 7-day free trial includes everything, no credit card required.
Side-by-side comparison
| Feature | Rheumatoid Arthritis | Polymyalgia Rheumatica |
|---|---|---|
| At a glance | Chronic symmetric inflammatory polyarthritis with autoantibodies and erosive joint damage. | Inflammatory syndrome of shoulder and hip girdle stiffness in adults over 50; dramatic response to low-dose steroids. |
| Classic presentation | Symmetric MCP/PIP/wrist swelling with positive MCP/MTP squeeze test, plus rheumatoid nodules in seropositive disease.; Insidious symmetric polyarthritis of small joints (MCP, PIP, wrists, MTPs); Morning stiffness lasting >1 hour, improving with activity; Fatigue, low-grade fever, weight loss; Hand weakness and difficulty with grip;… | Subacute onset of bilateral shoulder and hip girdle aching and stiffness; Morning stiffness >45 minutes (often hours); Difficulty rising from a chair or lifting arms above the head; Constitutional symptoms in 30-50%: fatigue, low-grade fever, anorexia, weight loss; No true muscle weakness once pain is controlled; Restricted active… |
| Workup / key labs | 2010 ACR/EULAR classification: score ≥6 of 10 across (a) joint involvement, (b) serology (RF/anti-CCP), (c) acute-phase reactants, and (d) symptom duration ≥6 weeks classifies as RA.; RF and anti-CCP (anti-CCP higher specificity; both predict erosive disease); ESR and CRP (elevated, used to track activity); CBC (normocytic anemia of… | 2012 EULAR/ACR provisional criteria: age ≥50, bilateral shoulder pain, abnormal CRP or ESR, plus weighted morning stiffness, hip involvement, absence of other joint pain, and absence of RF/anti-CCP.; ESR — characteristically >40 mm/h (often >50-100); CRP elevated and may be more sensitive; CBC — normochromic normocytic anemia,… |
| Imaging | Plain radiographs of hands and feet — periarticular osteopenia, symmetric joint-space narrowing, marginal erosions (MTPs often earliest); Ultrasound or MRI — more sensitive for early synovitis and erosions before plain-film changes; Cervical spine flexion/extension films in established disease to assess atlantoaxial subluxation prior to… | Shoulder ultrasound or MRI — subacromial-subdeltoid bursitis, biceps tenosynovitis, glenohumeral synovitis (supportive but not required); Temporal artery ultrasound or biopsy if GCA features develop; PET-CT in atypical cases — can show large-vessel uptake |
| First-line treatment | Early DMARD therapy within 3 months of diagnosis — methotrexate is anchor drug; start 10-15 mg PO/SC weekly with folic acid 1 mg daily; Conventional DMARDs — methotrexate, hydroxychloroquine, sulfasalazine, leflunomide (often combined as 'triple therapy'); Bridging low-dose prednisone (≤10 mg/day) until DMARD takes effect; taper as… | Prednisone 12.5-25 mg/day — dramatic improvement within 48-72 hours is both therapeutic and diagnostic; Slow taper over 1-2 years guided by symptoms and inflammatory markers (typical schedule: reduce by 2.5 mg every 2-4 weeks until 10 mg, then 1 mg every 1-2 months); Bone-protective therapy: calcium 1000-1200 mg/day, vitamin D 800-2000… |
Drill Rheumatoid Arthritis vs Polymyalgia Rheumatica questions on FirstPassPA
Turn this comparison into retention. 6,400+ board-style questions with an AI tutor that explains every answer — free to start, no card required.
Start studying free → Try today's free questionEducational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA or PAEA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants; End of Rotation™ is a program of the Physician Assistant Education Association.