• A Salet and H C Haanen.
• St. Antonius Ziekenhuis, afd. Interne Geneeskunde en Reumatologie, Nieuwegein.
• Ned Tijdschr Geneeskd. 1995 Apr 8; 139 (14): 727-30.

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

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