Arthritis of Polymyalgia Rheumatica
Approximately 50% of patients develop peripheral joint manifestations. Nonerosive, asymmetric distal joint arthritis has been described in up to 30% of cases.
Knee effusions, wrist synovitis (often with carpal tunnel syndrome), and sternoclavicular arthritis are detected most frequently. Knee effusions can be large (30–150 mL). Ankle and metatarsophalangeal (MTP) arthritis is rare and should prompt consideration of another diagnosis. Other peripheral manifestations include remitting seronegative symmetric synovitis with pitting edema, i.e., RS3PE syndrome, and tenosynovitis of the extensor tendons of the hands. These may be present initially or occur later during the course of PMR.
