Polyarthralgia is a common presentation in primary care. While the true incidence is unknown, 35% of a large UK community cohort aged over 55 years reported pain in more than one joint. Polyarthralgia is more common in women and with increasing age. Patients often present a diagnostic and management challenge. However, early assessment and diagnosis is important, as there is increasing evidence of the benefit of early intervention in patients with inflammatory arthritis. A window of opportunity exists where the benefits of early treatment may be significant and long-lasting.