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.
2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative / B., Dasgupta; M. A., Cimmino; H., Maradit Kremers; W. A., Schmidt; M., Schirmer; C., Salvarani; A., Bachta; C., Dejaco; C., Duftner; H. S., Jensen; P., Duhaut; G., Poor; N. P., Kaposi; P., Mandl; P. V., Balint; Z., Schmidt; Iagnocco, Annamaria; C., Nannini; F., Cantini; P., Macchioni; N., Pipitone; M. D., Amo; G., Espigol Frigole; M. C., Cid; V. M., Martinez Taboada; E., Nordborg; H., Direskeneli; Ahmed K., Aydin Sz; B., Hazleman; B., Silverman; C., Pease; R. J., Wakefield; R., Luqmani; A., Abril; C. J., Michet; R., Marcus; N. J., Gonter; M., Maz; R. E., Carter; C. S., Crowson; E. L., Matteson. - In: ANNALS OF THE RHEUMATIC DISEASES. - ISSN 0003-4967. - STAMPA. - 71:4(2012), pp. 484-492. [10.1136/annrheumdis-2011-200329]
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 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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
