Premium
Diagnostic performance of the 2012 EULAR/ACR classification criteria for polymyalgia rheumatica in Korean patients
Author(s) -
Lee KyungAnn,
Kim HyunSook,
Lee SangHeon,
Kim HaeRim
Publication year - 2020
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13923
Subject(s) - medicine , polymyalgia rheumatica , rheumatism , rheumatology , shoulders , rheumatoid arthritis , receiver operating characteristic , population , physical therapy , surgery , vasculitis , giant cell arteritis , disease , environmental health
Abstract Aim This prospective study aimed to evaluate the diagnostic performance of the 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria for polymyalgia rheumatica (PMR) compared to that of previous classification/diagnostic criteria in the Korean population. Method We consecutively included 77 patients aged ≥50 years presenting with bilateral shoulder pain and elevated acute‐phase reactants. All patients were evaluated for fulfillment of each of the 5 different criteria for PMR (Chuang et al, Bird, Jones and Hazleman, Healey, and the EULAR/ACR criteria). At baseline, bilateral ultrasound (US) examinations of the shoulders and hips were performed. Final diagnosis was made by an experienced rheumatologist at the 12‐month follow‐up. The area under the curve (AUC), sensitivity, and specificity of criteria sets were assessed. Results At the end of follow‐up, 38 and 39 patients were diagnosed with PMR and non‐PMR including rheumatoid arthritis (RA, n = 20), respectively. The EULAR/ACR classification criteria with US showed the best discriminating capacity (AUC 0.843). Adding US to EULAR/ACR criteria increased specificity from 74.4% to 89.7%, but decreased sensitivity from 89.5% to 78.9%. The two US items of the EULAR/ACR criteria were significantly more frequent in patients with PMR than in controls. However, the second criterion consisting of both shoulders inflamed were similar between PMR (60.5%) and RA (60.0%) groups. Conclusion The 2012 EULAR/ACR classification criteria for PMR performed best in classifying PMR from other inflammatory and non‐inflammatory disorders with shoulder pain in Asian populations.