To determine the characteristics and the course of chronic arthralgia (CA) and the differences from newly diagnosed rheumatoid arthritis (RA).
Retrospective, with a follow up after 2.5 years.
Outpatient clinic for rheumatology of the St. Antonius Hospital, Nieuwegein, The Netherlands.
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.
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.
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.