Table 5

Parameters considered as ‘important’ to define relapse of polymyalgia rheumatica by at least 80% of rheumatologists (RMs)

ParameterLimitsAgreement (%)
Morning stiffness*>30 min94.7
+20%5.3
Erythrocyte sedimentation rate*>40 mm/1st h57.9
>20 mm/1st h36.8
≥2 × previous5.3
C-reactive protein* >1.0 mg/dl52.6
>0.5 mg/dl21.1
>2.0 mg/dl15.9
≥2 × previous10.5
Patient's assessment of pain related to neck, upper arms, shoulders and pelvic girdle (VAS)*>20 mm93.8
>50 mm6.2
Corticosteroid dose required to control symptoms*Any dose62.4
↑ +2.5 mg/day31.2
≥10 mg/day6.2
Shoulder pain worsened by passive and active mobilisationQualitative item
Limitation of upper limb elevationQualitative item
Clinical sign of coxofemoral synovitisQualitative item
  • The corresponding proposals for a limit of metric parameters and the agreement rate to these limits are given.

  • * Consensus on this parameter was already obtained in the first Delphi round.

  • Upper limit of a normal C-reactive protein value is 0.5 mg/dl.

  • Coxofemoral synovitis is suggested if the patient complains about pain in the groin worsened by passive and active movements on clinical examination.

  • VAS, visual analogue scale with 0=no pain, 10=unbearable pain on a 10 cm scale.