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著者: Bhaskar Dasgupta, Marco A Cimmino, Hilal Maradit Kremers, Wolfgang A Schmidt, Michael Schirmer, Carlo Salvarani, Artur Bachta, Christian Dejaco, Christina Duftner, Hanne Slott Jensen, Pierre Duhaut, Gyula Poór, Novák Pál Kaposi, Peter Mandl, Peter V Balint, Zsuzsa Schmidt, Annamaria Iagnocco, Carlotta Nannini, Fabrizio Cantini, Pierluigi Macchioni, Nicolò Pipitone, Montserrat Del Amo, Georgina Espígol-Frigolé, Maria C Cid, Víctor M Martínez-Taboada, Elisabeth Nordborg, Haner Direskeneli, Sibel Zehra Aydin, Khalid Ahmed, Brian Hazleman, Barbara Silverman, Colin Pease, Richard J Wakefield, Raashid Luqmani, Andy Abril, Clement J Michet, Ralph Marcus, Neil J Gonter, Mehrdad Maz, Rickey E Carter, Cynthia S Crowson, Eric L Matteson
雑誌名: Arthritis Rheum. 2012 Apr;64(4):943-54. doi: 10.1002/art.34356.
Abstract/Text
The objective of this study was to develop European League Against Rheumatism/American College of Rheumatology classification criteria for polymyalgia rheumatica (PMR). Candidate criteria were evaluated in a 6-month prospective cohort study of 125 patients with new-onset PMR and 169 non-PMR comparison subjects with conditions mimicking PMR. A scoring algorithm was developed based on morning stiffness >45 minutes (2 points), hip pain/limited range of motion (1 point), absence of rheumatoid factor and/or anti-citrullinated protein antibody (2 points), and absence of peripheral joint pain (1 point). A score ≥4 had 68% sensitivity and 78% specificity for discriminating all comparison subjects from PMR. The specificity was higher (88%) for discriminating shoulder conditions from PMR and lower (65%) for discriminating RA from PMR. Adding ultrasound, a score ≥5 had increased sensitivity to 66% and specificity to 81%. According to these provisional classification criteria, patients ≥50 years old presenting with bilateral shoulder pain, not better explained by an alternative pathology, can be classified as having PMR in the presence of morning stiffness >45 minutes, elevated C-reactive protein and/or erythrocyte sedimentation rate, and new hip pain. These criteria are not meant for diagnostic purposes.
Copyright © 2012 by the American College of Rheumatology.
PMID 22389040 Arthritis Rheum. 2012 Apr;64(4):943-54. doi: 10.1002/art.34356.
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