Bird et al evaluated different criteria for the diagnosis of polymylgia rheumatica. The authors are from the Royal National Hospital for Rheumatic Diseases at Bath, Nuffield Orthopaedic Centre at Oxford, and the University of Manchester.
Criteria for polymyalgia rheumatica:
(1) bilateral shoulder pain and/or stiffness
(2) time from onset of illness to development of the full blown picture less than 2 weeks (footnote 2 in Table 2)
(3) initial erythrocyte sedimentation rate (ESR) > 40 mm per hour
(4) duration of morning stiffness > 1 hour
(5) age >= 65 years of age
(6) depression and/or weight loss
(7) bilateral tenderness to palpation in the upper arms
The diagnosis of polymyalgia rheumatica is probable if one or both of the following are present:
(1) >= 3 of these criteria present
(2) >=1 of these criteria AND presence of temporal arteritis
Clinical improvement to a therapeutic trial of corticosteroids can make the diagnosis more certain.
Performance:
• The sensitivity when >= 3 criteria are present was 80% (page 437).
