2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative

Dasgupta, B.; Cimmino, M. A.; Maradit Kremers, H.; Schmidt, W. A.; Schirmer, M.; Salvarani, C.; Bachta, A.; Dejaco, C.; Duftner, C.; Jensen, H. S.; Duhaut, P.; Poor, G.; Kaposi, N. P.; Mandl, P.; Balint, P. V.; Schmidt, Z.; Iagnocco, Annamaria; Nannini, C.; Cantini, F.; Macchioni, P.; Pipitone, N.; Amo, M. D.; Espigol Frigole, G.; Cid, M. C.; Martinez Taboada, V. M.; Nordborg, E.; Direskeneli, H.; Aydin Sz, Ahmed K.; Hazleman, B.; Silverman, B.; Pease, C.; Wakefield, R. J.; Luqmani, R.; Abril, A.; Michet, C. J.; Marcus, R.; Gonter, N. J.; Maz, M.; Carter, R. E.; Crowson, C. S.; Matteson, E. L.

doi:10.1136/annrheumdis-2011-200329

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; Annamaria Iagnocco; 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. - 71:4(2012), pp. 484-492.

Titolo:	2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative
Autori Riconosciuti:	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 mostra contributor esterni nascondi contributor esterni
Autori:	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; Annamaria Iagnocco; 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
Data di pubblicazione:	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.
Volume:	71
Fascicolo:	4
Pagina iniziale:	484
Pagina finale:	492
Digital Object Identifier (DOI):	10.1136/annrheumdis-2011-200329
URL:	http://ard.bmj.com/
Parole Chiave:	arthritis; clinical-outcomes; diagnostic uncertainty; erythrocyte sedimentation-rate; features; giant-cell arteritis; guidelines; management; population-based cohort; quality-of-life
Rivista:	ANNALS OF THE RHEUMATIC DISEASES
Appare nelle tipologie:	03B-Review in Rivista / Rassegna della Lett. in Riv. / Nota Critica

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