Comparison of polymyalgia rheumatica (PMR) criteria. Adapted from Dasgupta, et al. Arthritis Rheum 2006;55:518–209; with permission.
| Bird & Wood | Chuang & Hunder | Healey | Jones & Hazleman | EULAR/ACR without MSUS | EULAR/ACR with MSUS | ||
|---|---|---|---|---|---|---|---|
| (1) | Age, yrs | > 65 | ≥ 50 | > 50 | — | ≥ 50 (obligatory) | ≥ 50 (obligatory) |
| (2) | Bilateral pain of neck, shoulders, and pelvic girdle | Shoulders | Any 2 | Any | Shoulders and pelvic girdle | Shoulders (obligatory) Hips (1 point) | Shoulders (obligatory) Hips (1 point) |
| (3) | ESR | ≥ 40 mm/h | > 40 mm/h | Elevated | > 30 mm/h and/or CRP > 6 mg/l | Elevated ESR and/or CRP (obligatory) | Elevated ESR and/or CRP (obligatory) |
| (4) | Morning stiffness | > 1 h | ≥ 30 min | > 1 h | Yes | > 45 min (2 points) | > 45 min (2 points) |
| (5) | Duration of symptoms | Rapid onset < 2 weeks | ≥ 1 mo | — | ≥2 mo unless treated | — | — |
| (6) | Depression and/or weight loss | Yes | — | — | — | — | — |
| (7) | Bilateral upper arm tenderness | Yes | — | — | — | — | — |
| (8) | Exclusion of other diagnoses | — | Yes | Absence of RF and ANA | Yes | Absence of RF or ACPA (2 points) Absence of other joint involvement (1 point) | Absence of RF or ACPA (2 points) Absence of other joint involvement (1 point) |
| (9) | Rapid response to corticosteroids | — | — | ≤ 20 mg prednisone | Yes | — | — |
| (10) | MSUS | — | — | — | — | — | 1 shoulder and 1 hip (1 point) Both shoulders (1 point) |
| Diagnosis | Any 3 | All above | (1) and (8) obligatory, plus any 3 of (2), (3), (4) or (9) | All above | (1), (2) and (3) obligatory, plus a score of 4 or more points | (1), (2) and (3) obligatory, plus a score of 5 or more points |
EULAR/ACR: European League Against Rheumatism/American College of Rheumatology criteria for PMR; MSUS: musculoskeletal ultrasound; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; RF: rheumatoid factor; ACPA: anti-citrullinated protein antibody; ANA: antinuclear antibodies.