How is Polymyalgia Rheumatica diagnosed?

Polymyalgia Rheumatica (PMR) is a condition characterized by widespread pain and stiffness in the muscles, particularly in the shoulders, neck, and hips. It primarily affects individuals over the age of 50 and is more common in women than men. Diagnosing PMR can be challenging as its symptoms can mimic other conditions, but there are several key steps involved in the diagnostic process.

Medical History: The first step in diagnosing PMR is a thorough medical history evaluation. The doctor will ask about the patient's symptoms, their duration, and any factors that may exacerbate or alleviate the pain and stiffness. They will also inquire about the patient's medical history, including any previous illnesses or conditions.

Physical Examination: A comprehensive physical examination is crucial in diagnosing PMR. The doctor will assess the patient's range of motion, joint tenderness, and muscle strength. They will pay particular attention to the shoulders, neck, and hips, as these are the most commonly affected areas in PMR.

Blood Tests: Blood tests are an essential component of the diagnostic process for PMR. The doctor will typically order two specific blood tests:

• Erythrocyte Sedimentation Rate (ESR): This test measures the rate at which red blood cells settle in a test tube over a specific period. In PMR, the ESR is often significantly elevated, indicating the presence of inflammation in the body.


• C-Reactive Protein (CRP): CRP is a protein produced by the liver in response to inflammation. Elevated levels of CRP in the blood can suggest the presence of an inflammatory condition like PMR.

Imaging Tests: In some cases, imaging tests may be ordered to rule out other conditions or to assess the extent of inflammation. X-rays or ultrasound scans can help visualize the affected joints and rule out other potential causes of pain and stiffness.

Response to Treatment: One of the most significant diagnostic indicators for PMR is the patient's response to treatment. PMR typically responds well to low doses of corticosteroids, such as prednisone. If the patient experiences a significant improvement in symptoms after starting corticosteroid treatment, it strongly suggests a diagnosis of PMR.

Exclusion of Other Conditions: Since the symptoms of PMR can overlap with other conditions like rheumatoid arthritis or fibromyalgia, it is crucial to exclude these possibilities. The doctor may order additional tests or refer the patient to a rheumatologist for further evaluation if there is uncertainty in the diagnosis.

It is important to note that the diagnostic process for PMR may vary from person to person, and additional tests or evaluations may be required based on individual circumstances. Therefore, it is essential to consult with a healthcare professional for an accurate diagnosis.