Polymyalgia rheumatica diagnostic study of choice: Difference between revisions
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===PMR Diagnostic Criteria Scoring With Ultrasound=== | ===PMR Diagnostic Criteria Scoring With Ultrasound=== | ||
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| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 70%" align=center |'''Variable'''||style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF" align=center |'''Points''' | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | Morning stiffness for 45 minutes|| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |2 | |||
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| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Pain or limited range of motion in the hips||style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |1 | |||
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| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Absence of [[rheumatoid factor]] or [[anti-citrullinated protein antibody]]||style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |2 | |||
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| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |No involvement of other joints||style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |1 | |||
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| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |At least 1 shoulder with subdeltoid bursitis <br> AND/OR <br> biceps tenosynovitis <br> AND/OR <br> Glenohumeral synovitis (either posterior or axillary) <br> AND <br> at least 1 hip with synovitis and/or trochanteric bursitis|| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |1 | |||
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| style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |Both shoulders with subdeltoid bursitis, biceps tenosynovitis, or glenohumeral synovitis || style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |1 | |||
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==References== | ==References== | ||
Revision as of 22:18, 1 June 2014
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Polymyalgia Rheumatica Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Overview
The diagnosis of PMR is mostly clinical and is supported with an elevated ESR and specific findings on ultrasound of the affected joints. The European League Against Rheumatism/American College of Rheumatology collaborative initiative developed a provisional classification criteria for polymyalgia rheumatica. The following criteria are required: age 50 years, bilateral shoulder aching, and abnormal C-reactive protein (CRP and/or erythrocyte sedimentation rate (ESR).
Diagnostic Criteria
- Shown below is the 2012 provisional classification criteria for polymyalgia rheumatica by the European League Against Rheumatism/American College of Rheumatology collaborative initiative. Each of the findings is given a point, then the total score is calculated by adding all the point. Two scores have been developed depending on whether an ultrasound is performed or not.
- The following criteria are required in addition to the confirmatory score of the diagnostic criteria:
- Age 50 years, AND
- Bilateral shoulder pain, AND
- Elevated CRP and/or ESR
PMR Diagnostic Criteria Scoring Without Ultrasound
| Variable | Points |
| Morning stiffness for 45 minutes | 2 |
| Pain or limited range of motion in the hips | 1 |
| Absence of rheumatoid factor or anti-citrullinated protein antibody | 2 |
| No involvement of other joints | 1 |
PMR Diagnostic Criteria Scoring With Ultrasound
| Variable | Points |
| Morning stiffness for 45 minutes | 2 |
| Pain or limited range of motion in the hips | 1 |
| Absence of rheumatoid factor or anti-citrullinated protein antibody | 2 |
| No involvement of other joints | 1 |
| At least 1 shoulder with subdeltoid bursitis AND/OR biceps tenosynovitis AND/OR Glenohumeral synovitis (either posterior or axillary) AND at least 1 hip with synovitis and/or trochanteric bursitis |
1 |
| Both shoulders with subdeltoid bursitis, biceps tenosynovitis, or glenohumeral synovitis | 1 |