referral criteria from primary care (polymyalgia rheumatica)
Last reviewed 10/2023
This condition is normally managed satisfactorily in primary care.
Early specialist referral is recommended for:
- patients with atypical features or features that increase likelihood of a non-PMR diagnosis:
- younger patient < 60 years
- chronic onset
- lack of shoulder involvement
- lack of inflammatory stiffness
- ‘Red flag’ features: prominent systemic features, weight loss, night pain, neurological signs
- peripheral arthritis or other features of CTD/ muscle disease
- normal or very high ESR/CRP
- or treatment dilemmas such as:
- incomplete or non-response to corticosteroids
- ill-sustained response
- unable to reduce corticosteroid dose
- need for prolonged corticosteroid therapy (longer than two years)
- contra-indications to corticosteroid therapy
Reference: