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Medicine Immunology and Rheumatology 9106491b

Which is not included in Polymyalgia rheumaticacriteria (Healey criteria)?

A
Morning stiffness more than equal to 1 hour
B
Involvement of neck, shoulder, back for more than 6 months in a year
C
ESR > 40 mm/hr
D
Rapid response to prednisolone < 20 mg/day
High-Yield Explanation
Ans: (b) Involvement of neck, shoulder, back for more than 6 months in a yearRef: Kelley and Firesteins, Textbook of Rheumatology, 10th edition, Page 1521Diagnostic and Classification Criteria for Polymyalgia Rheumatica"Diagnostic Criteria of Chuang and Colleagues (1982)1. Age 50 years or older2. Bilateral aching and stiffness for 1 month or more and involving two of the following areas: neck or torso, shoulders or proximal regions of the arms, and hips or proximal aspects of the thighs3. ESR>40mm/hr4. Exclusion of all other diagnoses except giant cell arteritis"Diagnostic Criteria of Healey (1984)1. Pain persisting for at least 1 month and involving two of the following areas: neck, shoulders and pelvic girdle2. Morning stiffness lasting>1hr3. Rapid response to prednisone (<=20 mg/day)4. Absence of other diseases capable of causing the musculoskeletal symptoms5. Age older than 50 years6. ESR>40mm/hr'For each set of criteria, all the findings must be present for polymyalgia rheumatica to be diagnosed.

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