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The lack of a laboratory test causes difficulties in distinguishing true polymyalgia rheumatica (PMR) from other inflammatory rheumatic diseases.1 An important differential diagnosis is rheumatoid arthritis (RA), which has been reported to develop in up to a third of patients.2
Antibodies to cyclic citrullinated peptides (CCP) are considered to have 96% specificity for RA.3 A study comparing 57 patients with elderly onset RA with 49 patients with PMR found that 65% in the first group were anti-CCP positive, whereas none of the patients with PMR were positive.4
We have reported on a continuing prospective inception PMR cohort study of clinical outcomes, quality of life and diagnostic uncertainty of patients recruited before the start of …
Competing interests: None declared.
Ethical approval: Ethical approval was received from the Trent Multicentre Research Ethics Committee (reference MREC/00/4/041).
PMR Outcomes Study members: CT Pease, DGI Scott, B Bourke, K Chakravarty, B Hazleman, B Silverman, D Lamping, N Gendi.
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