Scoring algorithm with and without optional ultrasound criterion—required criteria: age 50 years or greater, bilateral shoulder aching and abnormal CRP and/or ESR
| Clinical criteria (without ultrasound)* | Criteria including ultrasound† | |||
|---|---|---|---|---|
| Criteria | Odds ratio (95% CI) | Points | Odds ratio (95% CI) | Points |
| Morning stiffness duration >45 min | 6.2 (3.2 to 11.8) | 2 | 5.0 (2.8 to 9.1) | 2 |
| Hip pain or limited range of motion | 2.1 (1.1 to 4.0) | 1 | 1.4 (0.8 to 2.6) | 1 |
| Absence of RF or ACPA | 3.0 (1.3 to 6.8) | 2 | 5.2 (2.1 to 12.6) | 2 |
| Absence of other joint pain | 2.7 (1.4 to 5.0) | 1 | 2.2 (1.3 to 4.0) | 1 |
| Ultrasound criteria | ||||
| At least one shoulder with subdeltoid bursitis and/or biceps tenosynovitis and/or glenohumeral synovitis (either posterior or axillary) and at least one hip with synovitis and/or trochanteric bursitis | 2.6 (1.3 to 5.3) | 1§ | ||
| Both shoulders with subdeltoid bursitis, biceps tenosynovitis or glenohumeral synovitis | 2.1 (1.2 to 3.7) | 1¶ | ||
ACPA, anticitrullinated protein antibody; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; RF, rheumatoid factor; CI, confidence interval.
↵* The optimal cut point is 4. A patient with a score of 4 or more is categorised as having polymyalgia rheumatica (PMR).
↵† The optimal cut point is 5. A patient with a score of 5 or more is categorised as having PMR.
↵§ P = 0.008.
↵¶ P = 0.009.