#5-89E. Phenotypic Convergence: Unmasking Late-Onset Rheumatic Diseases Fulfilling PMR Criteria (Arthritis Rheumatol, 2026)

Why do multiple late-onset inflammatory conditions present with identical shoulder and hip pain, frequently meeting polymyalgia rheumatica classification criteria? This review introduces the concept of phenotypic convergence, demonstrating how diverse diseases—including late-onset spondyloarthritis, VEXAS syndrome, and checkpoint inhibitor-associated arthritis—target a shared periarticular substrate despite distinct immunopathologies and frequent steroid-taper failure. Although narrative synthesis relies on heterogeneous observational cohorts requiring cautious extrapolation, these insights are vital. Recognizing steroid resistance, atypical imaging, and extra-articular features empowers clinicians to unmask PMR mimics and initiate timely, targeted therapies.

Citation: Abacar K, Altaie A, Barr A, Mackie SL, Mankia K, McGonagle D. Shared and Distinguishing Features of Late-Onset Rheumatic Diseases Fulfilling Polymyalgia Rheumatica Classification Criteria. Arthritis & Rheumatology. 2026.

URL: https://doi.org/10.1002/art.70339

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