2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative

Ann Rheum Dis. 2012 Apr;71(4):484-92. doi: 10.1136/annrheumdis-2011-200329.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Arthritis, Rheumatoid / diagnosis
  • Biomarkers / blood
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Diagnosis, Differential
  • Female
  • Glucocorticoids / therapeutic use
  • Hip Joint / physiopathology
  • Humans
  • International Cooperation
  • Male
  • Middle Aged
  • Pain / etiology
  • Polymyalgia Rheumatica / complications
  • Polymyalgia Rheumatica / diagnosis*
  • Polymyalgia Rheumatica / drug therapy
  • Prospective Studies
  • Range of Motion, Articular
  • Sensitivity and Specificity
  • Shoulder Pain / etiology

Substances

  • Biomarkers
  • Glucocorticoids
  • C-Reactive Protein