title: 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative.
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.
authors.affiliation: Department of Rheumatology, Southend University Hospital, Westcliff-on-Sea, Essex, UK.
authors.forename: Bhaskar
authors.initials: B
authors.lastname: Dasgupta
authors.forename: Marco A
authors.initials: MA
authors.lastname: Cimmino
authors.forename: Hilal
authors.initials: H
authors.lastname: Maradit-Kremers
authors.forename: Wolfgang A
authors.initials: WA
authors.lastname: Schmidt
authors.forename: Michael
authors.initials: M
authors.lastname: Schirmer
authors.forename: Carlo
authors.initials: C
authors.lastname: Salvarani
authors.forename: Artur
authors.initials: A
authors.lastname: Bachta
authors.forename: Christian
authors.initials: C
authors.lastname: Dejaco
authors.forename: Christina
authors.initials: C
authors.lastname: Duftner
authors.forename: Hanne Slott
authors.initials: HS
authors.lastname: Jensen
authors.forename: Pierre
authors.initials: P
authors.lastname: Duhaut
authors.forename: Gyula
authors.initials: G
authors.lastname: Poór
authors.forename: Novák Pál
authors.initials: NP
authors.lastname: Kaposi
authors.forename: Peter
authors.initials: P
authors.lastname: Mandl
authors.forename: Peter V
authors.initials: PV
authors.lastname: Balint
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Schmidt
authors.forename: Annamaria
authors.initials: A
authors.lastname: Iagnocco
authors.forename: Carlotta
authors.initials: C
authors.lastname: Nannini
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Cantini
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Macchioni
authors.forename: Nicolò
authors.initials: N
authors.lastname: Pipitone
authors.forename: Montserrat Del
authors.initials: MD
authors.lastname: Amo
authors.forename: Georgina
authors.initials: G
authors.lastname: Espígol-Frigolé
authors.forename: Maria C
authors.initials: MC
authors.lastname: Cid
authors.forename: Víctor M
authors.initials: VM
authors.lastname: Martínez-Taboada
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Nordborg
authors.forename: Haner
authors.initials: H
authors.lastname: Direskeneli
authors.forename: Sibel Zehra
authors.initials: SZ
authors.lastname: Aydin
authors.forename: Khalid
authors.initials: K
authors.lastname: Ahmed
authors.forename: Brian
authors.initials: B
authors.lastname: Hazleman
authors.forename: Barbara
authors.initials: B
authors.lastname: Silverman
authors.forename: Colin
authors.initials: C
authors.lastname: Pease
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wakefield
authors.forename: Raashid
authors.initials: R
authors.lastname: Luqmani
authors.forename: Andy
authors.initials: A
authors.lastname: Abril
authors.forename: Clement J
authors.initials: CJ
authors.lastname: Michet
authors.forename: Ralph
authors.initials: R
authors.lastname: Marcus
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Gonter
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Maz
authors.forename: Rickey E
authors.initials: RE
authors.lastname: Carter
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Crowson
authors.forename: Eric L
authors.initials: EL
authors.lastname: Matteson
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001172:Arthritis, Rheumatoid / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011111:Polymyalgia Rheumatica / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012680:Sensitivity and Specificity; D020069:Shoulder Pain / Q000209:etiology
chemical_list: D015415:Biomarkers; D005938:Glucocorticoids; D002097:C-Reactive Protein