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.
2012 Provisional Classification Criteria for Polymyalgia Rheumatica A European League Against Rheumatism/American College of Rheumatology Collaborative Initiative / 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, Poor; Novák Pál, Kaposi; Peter, Mandl; Peter V., Balint; Zsuzsa, Schmidt; Iagnocco, Annamaria; Carlotta, Nannini; Fabrizio, Cantini; Pierluigi, Macchioni; Nicolò, Pipitone; Montserrat Del, Amo; Georgina Espigol, Frigole; Maria C., Cid; Víctor M., Martinez Taboada; Elisabeth, Nordborg; Haner, Direskeneli; Ahmed K., Aydin Sz; 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. - In: ARTHRITIS AND RHEUMATISM. - ISSN 0004-3591. - STAMPA. - 64:4(2012), pp. 943-954. [10.1002/art.34356]
2012 Provisional Classification Criteria for Polymyalgia Rheumatica A European League Against Rheumatism/American College of Rheumatology Collaborative Initiative
IAGNOCCO, Annamaria;
2012
Abstract
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
