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2012 ACR/EULAR classification criteria for polymyalgia rheumatica
Classifies polymyalgia rheumatica in patients with new bilateral shoulder pain.
2012 ACR/EULAR classification criteria for polymyalgia rheumatica
Age 50 years or older
Mandatory entry criterion (not scored).
New bilateral shoulder aching
Mandatory entry criterion (not scored).
Abnormal CRP and/or ESR
Mandatory entry criterion (not scored).
Morning stiffness duration > 45 minutes
Hip pain or limited internal rotation
Absence of rheumatoid factor and/or anti-CCP antibody
Absence of other peripheral joint pain
ResultEntry criteria not met
These criteria apply only to patients aged >=50 with new bilateral shoulder aching and an abnormal CRP and/or ESR not better explained by another diagnosis.
- Point score (reference only)
- 0
When to use
- Classifying (not diagnosing) polymyalgia rheumatica in patients >=50 years with new bilateral shoulder pain for research/cohort purposes.
- Distinguishing PMR from shoulder conditions and late-onset rheumatoid arthritis that mimic it.
Formula
Requires age >=50, new bilateral shoulder aching, and abnormal CRP/ESR. Points: morning stiffness >45 min (2), hip pain or limited internal rotation (1), absent RF and/or anti-CCP (2), absence of other peripheral joint pain (1). Score >=4 (of 6) supports classification; adding shoulder/hip ultrasound findings can raise the maximum to 8 with a cut-off of >=5.
Pearls and pitfalls
- A provisional classification tool for research cohorts, not a diagnostic instrument for individual patients.
- Corticosteroid response is not part of the score but was used to help confirm the diagnosis when developing the criteria.