Polymyalgia rheumatica - Diagnosis

Diagnosis-Polymyalgia rheumatica




Diagnosing polymyalgia rheumatica (PMR) can often be quite a lengthy process involving several different tests.
This is because the condition shares many symptoms with more common health conditions, such as rheumatoid arthritis, which need to be ruled out first.

Tests

There's no specific test for polymyalgia rheumatica, but it's likely that a series of blood tests will be carried out.
Two blood tests – erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) – can be used to check the levels of inflammation in your body.
If the ESR and CRP test results are normal, it’s unlikely that polymyalgia rheumatica will be diagnosed.
Sometimes the ESR may be normal and the CRP may be raised, which would be more likely to indicate a positive diagnosis. This is why both tests are usually carried out at the same time.
As inflammation is a feature of many conditions, high levels don't automatically mean you have polymyalgia rheumatica.
Further tests may be needed to help rule out other conditions that cause inflammation. For example, a test for rheumatoid factor and anti-CCP antibodies may be carried out to rule out rheumatoid arthritis.
Blood tests can also help determine:
You may also have a urine test to check how well your kidneys are functioning.
X-rays and ultrasound scans may also be used to look at the condition of your bones and joints.

Symptom checklist

After other possible causes of your symptoms have been ruled out, a checklist can be used to see whether your symptoms match those most commonly associated with polymyalgia rheumatica.
A confident diagnosis of polymyalgia rheumatica can usually be made if you meet all of the following criteria:
  • you're over 50 years of age 
  • you have pain in your shoulders or your hips
  • you have stiffness in the morning that lasts longer than 45 minutes
  • your symptoms have lasted for more than two weeks
  • blood tests show raised levels of inflammation in your body
  • your symptoms rapidly improve after treatment with corticosteroids
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