▸ Step 4, the final stage in the diagnostic process, is follow-up at 4-6 weeks to make sure no alternative diagnoses have come to the fore.
When it comes to distinguishing PMR from seronegative arthropathies, there are two useful clues. First, keep in mind that synovitis of more than 6 weeks' duration is more likely to be an inflammatory arthropathy. Second, a patient who has both bilateral shoulder pain and bilateral hip pain is more likely to have PMR, Dr. Dasgupta said in response to a question from the audience.
But when it's really tough to make the distinction, the most practical issue is simply whether the patient in question responds to low-dose steroids.
“If a patient like this hasn't responded to 5 or 6 weeks of prednisone at 15-20 mg/day, you—d probably want to consider starting a DMARD,” he said.
Disclosures: Dr. Dasgupta's study is funded by grants from both the ACR and EULAR.
'We have a group of patients …who are currently unclassifiable. So we need to do more work.'
Source DR. DASGUPTA