investigation

Last reviewed 05/2021

Investigation in PMR is used to support the diagnosis as well as to rule out any other possible causes. BSR guidelines recommends the following investigations in polymyalgia rheumatica:

  • ESR
    • usually raised and returns to normal with treatment
    • in some patients low or normal rates have been reported as well
  • CRP
    • more sensitive marker
    • usually elevated (1)
  • full blood count - reveals a normochromic, normocytic anaemia in many cases (2)
  • investigations which should be carried out to exclude other conditions before starting steroid treatment include
    • rheumatoid factor (and anti-citrullinated peptide antibody if available) - negative
    • liver function
    • urea and electrolytes (1)
    • myeloma screen including protein electrophoresis and examination of urine for Bence Jones protein
    • thyroid stimulating hormone
    • calcium, alkaline phosphatase
    • creatine kinase
    • dipstick urinalysis
    • chest radiograph e.g., if prominent systemic symptoms
    • ANA (1)

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