I have been diagnosed with PMR 9 months ago. Pain came on rapidly over a weeks time, and started primarily in hips and somewhat in shoulders. Went to GP and did a prednisone taper starting with 50mg and tapering to 10mg. Felt better within a day and pain gone in 2 days. But once done with taper, pains came back within 4 days. Over the next 8 months I have been on prednisone constantly, as high as 15mg and docs keep wanting me to reduce to 5mg. I never get there and pain gets bad and have to go up to either 15mg (no pain) or 10mg with some ibprofen to supplement. Pain in hips has gotten progressively better but shoulders got worse where it was hard to put on shirt or coat and hard to raise arm above shoulder level. That was 3 months ago. Now am seeing a Rhumatologist and he now has me on Methotrexate in addition to prednisone. He did that with the intent on the metho to be able to reduce prednisone to 5mg or less. Pain in hips and shoulders is nearly gone now at 7mg prednisone and 20mg metho. But now have pain in both hands in the fingers with pain and swelling especially in morning. It was OK at 10mg prednisone but not at 7 or 8. So because of the pain and swelling in the fingers the Rhuemy now says I have RA, and that is why he is doing the metho. Try 20 and up to 25 if necessary.
My question to all you experienced PMR patients, does all this sound reasonable? Does pain in fingers rule out PMR now and is RA the correct diagnosis? My main reason for asking is that it seems to me that the PMR has simply started in some joints, been cured or nearly so in those joints but is making the circuit and traveling to others. Can PMR affect fingers in later stages. My ESR and CRP was elevated in early stages but now seems to be in norm at last check 3 months ago.
I appreciate your reponses. I am a 67 year old male living in USA