Table 1.
Different sets of criteria for the diagnosis and classification of PMR
Bird criteria, 1979 | Jones and Hazleman criteria, 1981 | Chuang and Hunder criteria, 1982 | Healey criteria, 1984 | ACR/EULAR criteria, 2012 | |
---|---|---|---|---|---|
Disease onset | Onset of illness within 2 weeks | Disease duration >2 months | Bilateral aching and stiffness ≥ 1 month in two of the following: neck/torso, shoulders/upper arms, hips/thighs | Persistent pain ≥1 month in two of the following: neck, shoulders, pelvic girdle | |
Morning stiffness | Morning stiffness >1 h | Morning stiffness >1 h | Morning stiffness >1 h | Morning stiffness >45 min (two points) | |
Shoulder/pelvic/hip pain | Bilateral shoulder pain with/without stiffness | Shoulder or pelvic girdle pain without muscle weakness | Hip pain/restricted range of motion (one point) | ||
Upper arm tenderness | Bilateral upper arm tenderness | ||||
Exclusions by signs/symptoms/laboratory values | Absence of objective signs of muscle disease | Absence of other joint involvement (one point) | |||
Absence of RF or anti-CCP antibodies (two points) | |||||
Age at onset | Age ≥ 65 years | Age ≥ 50 years | |||
ESR/CRP | Initial ESR ≥40mm/h | ESR >30 mm/h or CRP >6 mg/l | ESR >40 mm/h | ESR >40 mm/h | |
Absence of other rheumatic diseases | Absence of RA | Exclusion of other diagnosis, with the exception of GCA | Absence of other joint or musculoskeletal diseases | ||
Response to glucocorticoids | Fast and dramatic response to systemic glucocorticoids | Rapid response to prednisolone (≤20 mg/day) | |||
Signs on ultrasonography | If ultrasonography available, ≥ one shoulder with subdeltoid bursitis, biceps tenosynovitis or glenohumeral synovitis (posterior/axillary); and ≥ hip with synovitis/trochanteric bursitis (one point) | ||||
If ultrasonography available, both shoulders with subdeltoid bursitis, biceps tenosynovitis or glenohumeral synovitis (one point) | |||||
Depression/weight loss | Depression/weight loss | ||||
Requirements for diagnosis | Diagnosis of probable PMR requires at least three of the above criteria | All the above criteria required for diagnosis of PMR | All the above criteria required for diagnosis of PMR | Diagnosis of PMR requires the age of ≥50 years and the fulfilment of at least three criteria | Diagnosis with PMR requires the age of ≥50 years, bilateral shoulder aching, abnormal CRP/ESR levels and at least four points (without ultrasonography)/at least five points (with ultrasonography) |