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Bispebjerg Hospital - a part of Copenhagen University Hospital

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

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  • Bhaskar Dasgupta
  • Marco A Cimmino
  • Hilal Maradit Kremers
  • Wolfgang A Schmidt
  • Michael Schirmer
  • Carlo Salvarani
  • Artur Bachta
  • Christian Dejaco
  • Christina Duftner
  • Hanne Slott Jensen
  • Pierre Duhaut
  • Gyula Poór
  • Novák Pál Kaposi
  • Peter Mandl
  • Peter V Balint
  • Zsuzsa Schmidt
  • Annamaria Iagnocco
  • Carlotta Nannini
  • Fabrizio Cantini
  • Pierluigi Macchioni
  • Nicolò Pipitone
  • Montserrat Del Amo
  • Georgina Espígol-Frigolé
  • Maria C Cid
  • Víctor M Martínez-Taboada
  • Elisabeth Nordborg
  • Haner Direskeneli
  • Sibel Zehra Aydin
  • Khalid Ahmed
  • Brian Hazleman
  • Barbara Silverman
  • Colin Pease
  • Richard J Wakefield
  • Raashid Luqmani
  • Andy Abril
  • Clement J Michet
  • Ralph Marcus
  • Neil J Gonter
  • Mehrdad Maz
  • Rickey E Carter
  • Cynthia S Crowson
  • Eric L Matteson
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The objective of this study was to develop European League Against Rheumatism/American College of Rheumatology 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 rheumatoid factor and/or anti-citrullinated protein antibody (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 C-reactive protein and/or erythrocyte sedimentation rate, and new hip pain. These criteria are not meant for diagnostic purposes.
Original languageEnglish
JournalArthritis & Rheumatism
Issue number4
Pages (from-to)943-54
Number of pages12
Publication statusPublished - 2012

    Research areas

  • Aged, Aged, 80 and over, Arthritis, Rheumatoid, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Polymyalgia Rheumatica, Prospective Studies

ID: 36795397