Seronegative polyarthritis in giant cell arteritis

Abstract

Nineteen of 520 patients with biopsy‐proven giant cell arteritis were found to have persistent seronegative, symmetric polyarthritis with a mean joint count of 20 (swollen plus tender). In 9 patients in the onset of polyarthritis occurred prior to the diagnosis of giant cell arteritis, 3 had simultaneous onset, and 7 developed polyarthritis within 3 years after the onset of giant cell arteritis. Ten of the 19 patients demonstrated radiographic features of joint space narrowing and/or erosions. In 1 patient in a synovial biopsy was performed, revealing marked multinucleated giant cell infiltration. A persistent seronegative polyarthritis, although uncommon in giant cell arteritis, may be its presenting symptom. Other symptoms of giant cell arteritis should be sought in patients who exhibit this feature, especially in those whose arthritis begins at age 50 or older.

Distal extremity swelling with pitting edema in polymyalgia rheumatica. Report of nineteen cases

“…Although there are no pathognomonic findings in PMR, the patients in the cohort fulfilled the preset diagnostic criteria, and none have developed another disease since onset that would explain the findings. None of the patients developed persistent synovitis, as seen in RA, that may occasionally occur in patients who initially develop PMR or GCA (9).…”

Musculoskeletal manifestations in a population-based cohort of patients with giant cell arteritis

“…Among 520 patients with biopsy-proven GCA, Ginsburg and colleagues identified 22 who met criteria for RA (6). Three were seropositive with extensive deformities of the hands, and 10 of the 19 patients with seronegative disease also showed RA-type radiographic features.…”

“…In addition to the proximal limb girdle aching and stiffness characteristic of PMR, peripheral articular and periarticular manifestations have been described in up to one-third of GCA patients (2)(3)(4)(5)(6)(7)(8)(9)(10). However, the spectrum and frequency of the various musculoskeletal findings in patients with GCA have not been determined fully.…”