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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

Ann rheum dis

Publication Date

04/2012

Volume

71

Pages

484 - 492

Keywords

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