A follow-up study of 23 patients with polymyalgia rheumatica 3.2 yr after onset and 2.6 yr after diagnosis showed that (1) 15 of 16 still had abnormal joint scans; (2) 18 of 23 still needed antiinflammatory drugs; (3) 16 of 23 believed they still had the disease; (4) erythrocyte sedimentation rates were persistently elevated beyond the 90th percentile in 11 patients (47%); and (5) 7 of 18 patients with available roentgenograms had joint abnormalities. We suggest that polymyalgia rheumatica is a chronic arthritis affecting primarily the proximal joints.