The first-ever classification criteria for polymyalgia rheumatica (PMR), a common cause of widespread pain and stiffness in older patients, are designed to help physicians better identify patients who have this condition. The new criteria were released by the American College of Rheumatology (ACR) in collaboration with The European League Against Rheumatism.
The diagnosis of PMR often is difficult because the condition rarely causes swollen joints or other abnormalities that can be seen on a physical examination and there have been no well established criteria to recognize it, the ACR noted. The pain and stiffness associated with PMR are common symptoms caused by other illnesses in older persons, and there is a lack of standardized testing to confirm the disease, minimal scientific research evaluating therapies, and an absence of genetic markers to identify disease risk.
The new criteria for PMR will improve recognition by defining the disease features that are useful in classifying patients' symptoms. They also provide a structure that will facilitate a better understanding of the disease and its course and the development of new therapies and clinical trials.
Under the new criteria, patients aged 50 years and older may be classified as having PMR if they meet all of the following conditions:
• Shoulder pain on both sides.
• Morning stiffness that lasts at least 45 minutes.
• High levels of inflammation measured by protein in the blood and erythrocyte sedimentation rate.
• Reported new hip pain.
• An absence of swelling in the small joints of the hands and feet and an absence of positive blood test results for rheumatoid arthritis.
The new classification criteria also may help evaluate existing treatments for patients with PMR. However, they were created to provide guidance and not for diagnostic purposes, it was noted.
For more information, visit the ACR Web site at http://www.rheumatology.org. Or, contact the organization at American College of Rheumatology, 2200 Lake Boulevard NE, Atlanta, GA 30319; telephone: (404) 633-3777; fax (404) 633-1870.