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Polymyalgia rheumatica - Management
What diagnostic criteria are used for diagnosing polymyalgia rheumatica?
- Several sets of criteria for diagnosing polymyalgia rheumatica have been proposed, principally to aid research by ensuring uniformity within trials and to allow comparison of results from different studies. However, the criteria have also been used for clinical purposes.
- One report examined the performance of individual criteria and sets of criteria for making a diagnosis of polymyalgia rheumatica . The set of criteria proposed was found to be most useful (sensitivity 92%, specificity 80%, likelihood ratio 5).
- Polymyalgia rheumatica is diagnosed by the Bird criteria if three or more of the following are present:
- Bilateral shoulder pain or stiffness.
- Onset of illness less than 2 weeks previously.
- Initial erythrocyte sedimentation rate (ESR) greater than 40 mm per hour.
- Morning stiffness lasting longer than an hour.
- 65 years of age or more.
- Depression and/or weight loss.
- Bilateral tenderness in the upper arms.
- Diagnostic criteria drafted at the Third International Conference on Polymyalgia Rheumatica and Giant Cell Arteritis (July 2005) have also been published, and are currently being tested in a clinical trial.
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