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The objective of this study was to develop EULAR/ACR classification criteria for polymyalgia rheumatica (PMR). Candidate criteria were evaluated in a 6-month prospective cohort study of 125 patients with new onset PMR and 169 non-PMR comparison subjects with conditions mimicking PMR. A scoring algorithm was developed based on morning stiffness >45 minutes (2 points), hip pain/limited range of motion (1 point), absence of RF and/or ACPA (2 points), and absence of peripheral joint pain (1 point). A score ≥4 had 68% sensitivity and 78% specificity for discriminating all comparison subjects from PMR. The specificity was higher (88%) for discriminating shoulder conditions from PMR and lower (65%) for discriminating RA from PMR. Adding ultrasound, a score ≥5 had increased sensitivity to 66% and specificity to 81%. According to these provisional classification criteria, patients ≥50 years old presenting with bilateral shoulder pain, not better explained by an alternative pathology, can be classified as having PMR in the presence of morning stiffness>45 minutes, elevated CRP and/or ESR and new hip pain. These criteria are not meant for diagnostic purposes.

Original publication

DOI

10.1136/annrheumdis-2011-200329

Type

Journal article

Journal

Annals of the rheumatic diseases

Publication Date

04/2012

Volume

71

Pages

484 - 492

Addresses

Department of Rheumatology, Southend University Hospital, Westcliff-on-Sea, Essex, UK.

Keywords

Hip Joint, Humans, Shoulder Pain, Arthritis, Rheumatoid, Polymyalgia Rheumatica, Pain, C-Reactive Protein, Glucocorticoids, Diagnosis, Differential, Range of Motion, Articular, Blood Sedimentation, Sensitivity and Specificity, Prospective Studies, Age Factors, Algorithms, International Cooperation, Aged, Aged, 80 and over, Middle Aged, Female, Male, Biomarkers