Polyarthralgia is a common presentation in primary care. Because chronic arthritides may present abruptly, they need to be considered in patients who present with acute polyarticular pain. This pain poses a diagnostic challenge because of extensive differential diagnoses. Many classic rheumatological laboratory tests are non-specific and radiographs can be normal or show only non-specific changes early in the disease process. A thorough history and a complete physical examination are essential for accurate diagnosis.