Is My Joint Pain Caused by Rheumatoid Arthritis (RA) or Another Autoimmune Disorder?

Several autoimmune diseases can cause joint pain and other symptoms that mimic rheumatoid arthritis (RA). These diseases most commonly include lupus, systemic scleroderma, and polymyalgia rheumatic.

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Lupus vs. Rheumatoid Arthritis

A complex autoimmune disease, lupus can cause a wide range of symptoms that vary in severity, making it challenging to diagnose. Many people refer to lupus by its full medical name, systemic lupus erythematosus (SLE).

How is it similar to RA? One of the most common symptoms of lupus is pain and swelling in the hands, knees, and other joints. People often report fatigue, fever, and a general feeling of being unwell.

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How is it different? A person with lupus may find it painful to take a deep breath. He or she may have sensitivity to light, hair loss, mouth sores, and/or a skin rash, particularly over the face. Digestive difficulties and neurological problems, such as headaches and tingling, are also possible.

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Systemic Sclerosis vs. Rheumatoid Arthritis

Systemic sclerosis, sometimes called scleroderma, is a rare and complicated autoimmune condition. It produces a build-up of collagen in the body that can cause a wide variety of symptoms.

How is it similar to RA? The wrists, fingers, feet, and other joints can become painful, swollen, and stiff. People with systemic sclerosis can experience fatigue and weight loss.

How is it different? Scleroderma typically causes skin changes. (In Greek, sclero means hard and derma means skin.) For example, the skin may appear thickened and patchy or shiny and tight. Systemic scleroderma can also affect internal organs, resulting in breathing and/or digestive tract problems.

Polymyalgia Rheumatica vs. Rheumatoid Arthritis

This autoimmune disease is challenging to diagnose for two reasons. First, its symptoms overlap with many other inflammatory and autoimmune conditions. Second, it can cause a variety of symptoms, and an individual may experience just a few symptoms that are not considered typical to the disease.

How is it similar to RA? Polymyalgia rheumatica joint pain is often symmetrical (e.g. affecting both the right and left shoulders)¹Clifford A and Hoffman GS. Polymyalgia Rheumatica and Giant Cell Arteritis. Cleveland Clinic. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/polymyalgia-rheumatica-and-giant-cell-arteritis/#bib6. Published June 2014. Accessed March 24, 2016. and most noticeable after getting out of bed in the morning. In one study, researchers found inflammation of joints’ lining—a condition called synovitis, a classic sign of RA—in 23% of polymyalgia rheumatica cases.²Cutolo M, Cimmino A, Sulli A. Polymyalgia rheumatica vs late-onset rheumatoid arthritis. Rheumatology (2009) 48 (2): 93-95. http://rheumatology.oxfordjournals.org/content/48/2/93.full. Accessed March 24, 2016.

People with polymyalgia rheumatica also may feel like they have the flu, have a fever, feel weak, or experience weight loss.

Both RA and polymyalgia rheumatica are more common in Caucasian women.¹Clifford A and Hoffman GS. Polymyalgia Rheumatica and Giant Cell Arteritis. Cleveland Clinic. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/polymyalgia-rheumatica-and-giant-cell-arteritis/#bib6. Published June 2014. Accessed March 24, 2016.^,3Questions and Answers about Polymyalgia Rheumatica and Giant Cell Arteritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Polymyalgia/#poly1 Published April 2015. Accessed March 24, 2016.

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How is it different? Polymyalgia rheumatica usually affects the shoulders, neck, or hips first, whereas RA usually affects hands, feet, or knees first. People with polymyalgia rheumatica typically also experience muscle pain: myalgia means muscle pain, and polymyalgia means muscle pain in multiple locations.

Polymyalgia rheumatica is rarely diagnosed in people under age 50 and it is most commonly diagnosed in people between the ages 70 and 80. ¹Clifford A and Hoffman GS. Polymyalgia Rheumatica and Giant Cell Arteritis. Cleveland Clinic. http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/rheumatology/polymyalgia-rheumatica-and-giant-cell-arteritis/#bib6. Published June 2014. Accessed March 24, 2016.^,4Cantini F, Niccoli L, Storri L, Nannini C, Olivieri I, Padula A, Boiardi L, Salvarani C. Are polymyalgia rheumatica and giant cell arteritis the same disease? Semin Arthritis Rheum. 2004 Apr;33(5):294-301. Review. PubMed PMID: 15079760. As cited in Unwin B, Williams CM, Gilliland W. Polymyalgia rheumatica and giant cell arteritis. Am Fam Physician. 2006 Nov 1;74(9):1547-54. Review. PubMed PMID: 17111894. RA is more commonly diagnosed in people ages 30 to 60.

At least 10% of people with polymyalgia rheumatica also have a related disorder called giant cell arteritis.⁴Cantini F, Niccoli L, Storri L, Nannini C, Olivieri I, Padula A, Boiardi L, Salvarani C. Are polymyalgia rheumatica and giant cell arteritis the same disease? Semin Arthritis Rheum. 2004 Apr;33(5):294-301. Review. PubMed PMID: 15079760. As cited in Unwin B, Williams CM, Gilliland W. Polymyalgia rheumatica and giant cell arteritis. Am Fam Physician. 2006 Nov 1;74(9):1547-54. Review. PubMed PMID: 17111894. This condition has the potential to cause headaches, scalp pain and tenderness, vision problems, jaw pain, dizziness, and decreased coordination.