I have long appointments with my rheumatologist. She is thorough and listens to what I say. She does think out loud which may be disturbing to some. I understand where she is going and I understand she is throwing out possibilities not absolutes. I had a number of revelations but a big one was the possibility of adding polymyalgia rheumatica to my RA diagnosis. Both are autoimmune, inflammatory arthritis disorders that affect the elderly.
Polymyalgia rheumatica is an autoimmune disease that commonly affects the elderly. The highest prevalence is between 70 and 80. It classically affects the joints of the pelvic girdle and the shoulders bilaterally. Pain and stiffness. Muscle aching. Inflammatory pain in the neck affects some.
It is not a symmetrical disease as is RA. Inflammation in the knees and wrists is usually unilateral. It is not curable. It is manageable however. The drug of choice is corticosteroids which controls the symptoms. Prednisone is usually started around 25 mg for a month and then tapered to a dose that controls symptoms.
I felt relieved. It was manageable. There was a solution. Of course, one of the problems with polymyalgia rheumatica is its association with giant cell arteritis. Not good. 10% of those with polymyalgia rheumatica also have giant cell arteritis which is the inflammation of the lining of arteries particularly in the temporal arteries of the head. For now I will deal with managing what I have and be glad it is not worse.