To the Editor.
—I would like to commend Lauter et al1 on their comprehensive and lucid discussion of polymyalgia rheumatica (PMR). In particular, from my experience both as a consulting rheumatologist and as a faculty member instructing medical students, house staff, and primary care physicians, I would underline their description of PMR as a low-grade symmetric synovitis involving primarily large proximal joints. Partially because of its name, house staff and many primary care physicians think of PMR as a muscular disorder, confusing it with fibromyalgia syndrome and polymyositis. Indeed, the patient described by Lauter et al had a positive test for rheumatoid factor; it would be interesting to know if the patient presented at a later date with symmetric small-joint peripheral synovitis of rheumatoid arthritis.My only exception for treatment of PMR (and temporal arteritis) in the article by Lauter et al is "stressing repeated clinical observation and frequent
Kaplan RA. Polymyalgia Rheumatica. Arch Intern Med. 1985;145(11):2130. doi:10.1001/archinte.1985.00360110206049