[Chronic arthralgia: not a precursor of rheumatoid arthritis, but part of fibromyalgia syndrome].

OBJECTIVE

To determine the characteristics and the course of chronic arthralgia (CA) and the differences from newly diagnosed rheumatoid arthritis (RA).

DESIGN

Retrospective, with a follow up after 2.5 years.

SETTING

Outpatient clinic for rheumatology of the St. Antonius Hospital, Nieuwegein, The Netherlands.

METHOD

The diagnosis of CA was made in the period of June 1986-December 1988 in 74 patients. The CA patients were sent a questionnaire after a mean of 2.5 years and invited for another rheumatological examination; 62 patients responded (84%). Data were compared with all 52 RA patients newly diagnosed in the same period by the same specialist.

RESULTS

At the first visit CA had been present for 1 year, RA patients had had complaints for 0.6 years (p = 0.02). The RA patients had elevated BSE rates more often (31 vs. 8 mm in CA) (p < 0.0001) and more serious morning stiffness (75 vs. 0 minutes in CA) (p < 0.0001). The diagnosis of RA was made at the first visit in 86% and in 96% within half a year later. None of the CA patients developed an inflammatory joint disease within 2.5 years. In 1 out of 3 CA patients the diagnosis of fibromyalgia was made and more than 50% had complaints.

CONCLUSIONS

CA for more than 3 years does not predict inflammatory rheumatic disease. In contrast, RA develops in a short period and the diagnosis is made in 96% within 1 year. CA can be considered a feature of the fibromyalgia syndrome.