Parameters considered as ‘important’ to define relapse of polymyalgia rheumatica by at least 80% of rheumatologists (RMs)
| Parameter | Limits | Agreement (%) |
|---|---|---|
| Morning stiffness* | >30 min | 94.7 |
| +20% | 5.3 | |
| Erythrocyte sedimentation rate* | >40 mm/1st h | 57.9 |
| >20 mm/1st h | 36.8 | |
| ≥2 × previous | 5.3 | |
| C-reactive protein* † | >1.0 mg/dl | 52.6 |
| >0.5 mg/dl | 21.1 | |
| >2.0 mg/dl | 15.9 | |
| ≥2 × previous | 10.5 | |
| Patient's assessment of pain related to neck, upper arms, shoulders and pelvic girdle (VAS)* | >20 mm | 93.8 |
| >50 mm | 6.2 | |
| Corticosteroid dose required to control symptoms* | Any dose | 62.4 |
| ↑ +2.5 mg/day | 31.2 | |
| ≥10 mg/day | 6.2 | |
| Shoulder pain worsened by passive and active mobilisation | Qualitative item | |
| Limitation of upper limb elevation | Qualitative item | |
| Clinical sign of coxofemoral synovitis‡ | Qualitative 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.