Protocol For The Quantitation Of Pain In The Diagnosis Of Polymyalgia Rheumatica

This study is being conducted to evaluate a method for the quantifying of the proximal
tenderness in patients with presumed diagnosis of Polymyalgia Rheumatica(PMR)using the
measurements of pain thresholds(in both upper and lower arms) by the use of a standard blood
pressure cuff.

At the present time the diagnosis of PMR is based upon four classic criteria, History of
sudden onset symmetric painful proximal myopathy, Physical demonstrating proximal tenderness
without loss of motion passively, Laboratory evidence of significant inflammation: ESR>50 and
treatment with a rapidly beneficial response to low dose prednisone.

While the history, laboratory findings, and the response to prednisone are easily documented,
the complaint of tenderness and the physical response to that tenderness is difficult to
define and quantitate.

By better quantifying the tenderness and the physical response to that tenderness will, it is
hoped, lead to more rapid diagnosis as well as improved approach to treatment.

Three groups of patients will be studied. Each patient, after written informed consent and
procedure statement, will have pain threshold measurements taken and recorded by standard
blood pressure cuff 4 times: one each on the lower and upper arms. The blood pressure cuff
will be inflated to the level of maximum pain, then deflated, recording the maximum pain
level. Absolute numbers will be used for each measurement. Blood pressure will not be
recorded.

This study is an attempt to add definition to the diagnosis of Polymyalgia Rheumatica with a
both simple and rapid office exam.

Inclusion Criteria:

- Patients signing Informed Consent

Exclusion Criteria:

- Patients less than 50 years old