rheumatology

2012 ACR/EULAR Classification Criteria for Polymyalgia Rheumatica (PMR)

ACR/EULAR 2012 provisional criteria for classifying PMR in patients ≥50 years with new bilateral shoulder aching and elevated acute phase response. Score ≥4 (without USS) or ≥5 (with USS) = PMR classification.

Score interpretation

PMR Not Classified 0–3

Score <4 (or <5 with USS) — PMR classification criteria not met

→ Consider alternative diagnoses: RA (check RF, anti-CCP, joint X-rays), late-onset seronegative RA, malignancy, GCA, hypothyroidism, fibromyalgia, shoulder OA; rheumatology referral if uncertain

PMR Classified 4–7

Score ≥4 (or ≥5 with USS) — PMR classification criteria met

→ Confirm diagnosis clinically (bilateral shoulder pain, elevated ESR/CRP, age ≥50); prednisolone 15 mg daily and expect rapid response (48–72h); if no response in 1 week, reconsider diagnosis; monitor for GCA symptoms (headache, jaw claudication, visual symptoms); taper over 18–24 months; bone protection (bisphosphonate, calcium, vitamin D)

Interpretation bands for the PMR Criteria. Apply clinical judgement and local guidance.

References

Dasgupta B et al. 2012 provisional classification criteria for polymyalgia rheumatica: A European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum. 2012;64(4):943–954.

Curated clinical cross-links plus same-class fallbacks.

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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