Polymyalgia Rheumatica N008
Current RMA Instruments:
| Reasonable Hypothesis SOP | 19 of 2016 |
| Balance of Probabilities SOP | 20 of 2016 |
Changes from previous Instruments:
ICD Coding:
- ICD-9-CM Codes: 725
- ICD-10-AM Codes: M35.3
Brief description
Polymyalgia rheumatica is a clinical syndrome in which there is persistent muscle ache /stiffness at multiple sites. The neck, shoulder and hip regions are most commonly affected.
Confirming the diagnosis
There is no definitive test for this condition. Diagnosis is based on the characteristic history. Other possible causes for the symptoms need to be ruled out. An elevated erythrocyte sedimentation rate or C-reactive protein level and a rapid response to oral corticosteroids (predinisone) help to confirm the diagnosis.
The relevant medical specialist is a rheumatologist.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Polymyalgia rheumatica coexistent with giant cell arteritis/temporal arteritis*
* another SOP applies - covered by the giant cell arteritis SOP
Clinical onset
Onset may be sudden or gradual. Once the diagnosis has been confirmed, clinical onset can be backdated to when relevant, continuing sysmptoms first developed.
Clinical worsening
The only worsening factor is for inability to obtain appropriate clinical management. The normal course of isolated, treated polymyalgia rheumatica is for the condition to gradually resolve over 1 to 2 years. Complications from steroid treatment can arise but these are separate conditions and not worsening of the polymyalgia rheumatica.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/sops-grouped-icd-body-system/n-p/polymyalgia-rheumatica-n008-m353
Rulebase for polymyalgia rheumatica
<h5>Current RMA Instruments:</h5><table border="1" cellspacing="1" cellpadding="1"><tbody><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2016/019.pdf" target="_blank">Reasonable Hypothesis SOP</a></address></td><td>19 of 2016</td></tr><tr><td><address><a href="http://www.rma.gov.au/assets/SOP/2016/020.pdf" target="_blank">Balance of Probabilities SOP</a></address></td><td>20 of 2016</td></tr></tbody></table><h5>Changes from previous Instruments:</h5><p><drupal-media data-entity-type="media" data-entity-uuid="e3310479-13ad-4567-8ffe-c9b23bd34394" data-view-mode="wysiwyg"></drupal-media></p><h5>ICD Coding:</h5><ul><li>ICD-9-CM Codes: 725</li><li>ICD-10-AM Codes: M35.3</li></ul><h5><strong>Brief description</strong></h5><p>Polymyalgia rheumatica is a clinical syndrome in which there is persistent muscle ache /stiffness at multiple sites. The neck, shoulder and hip regions are most commonly affected.</p><h5>Confirming the diagnosis</h5><p>There is no definitive test for this condition. Diagnosis is based on the characteristic history. Other possible causes for the symptoms need to be ruled out. An elevated erythrocyte sedimentation rate or C-reactive protein level and a rapid response to oral corticosteroids (predinisone) help to confirm the diagnosis.</p><p>The relevant medical specialist is a rheumatologist. </p><h5><strong>Additional diagnoses covered by SOP</strong></h5><ul><li>Nil</li></ul><h5><strong>Conditions not covered by SOP </strong></h5><ul><li>Polymyalgia rheumatica coexistent with giant cell arteritis/temporal arteritis*</li></ul><p align="LEFT" dir="LTR"><sup><font size="2">*</font></sup> another SOP applies - covered by the giant cell arteritis SOP </p><h5><strong>Clinical onset</strong></h5><p>Onset may be sudden or gradual. Once the diagnosis has been confirmed, clinical onset can be backdated to when relevant, continuing sysmptoms first developed.</p><h5>Clinical worsening</h5><p>The only worsening factor is for inability to obtain appropriate clinical management. The normal course of isolated, treated polymyalgia rheumatica is for the condition to gradually resolve over 1 to 2 years. Complications from steroid treatment can arise but these are separate conditions and not worsening of the polymyalgia rheumatica.</p><h5> </h5>
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/n-p/rulebase-polymyalgia-rheumatica
Inability to obtain appropriate clinical management for polymyalgia rheumatica
Current RMA Instruments:
| Reasonable Hypothesis SOP | 19 of 2016 |
| Balance of Probabilities SOP | 20 of 2016 |
Changes from previous Instruments:
ICD Coding:
- ICD-9-CM Codes: 725
- ICD-10-AM Codes: M35.3
Brief description
Polymyalgia rheumatica is a clinical syndrome in which there is persistent muscle ache /stiffness at multiple sites. The neck, shoulder and hip regions are most commonly affected.
Confirming the diagnosis
There is no definitive test for this condition. Diagnosis is based on the characteristic history. Other possible causes for the symptoms need to be ruled out. An elevated erythrocyte sedimentation rate or C-reactive protein level and a rapid response to oral corticosteroids (predinisone) help to confirm the diagnosis.
The relevant medical specialist is a rheumatologist.
Additional diagnoses covered by SOP
- Nil
Conditions not covered by SOP
- Polymyalgia rheumatica coexistent with giant cell arteritis/temporal arteritis*
* another SOP applies - covered by the giant cell arteritis SOP
Clinical onset
Onset may be sudden or gradual. Once the diagnosis has been confirmed, clinical onset can be backdated to when relevant, continuing sysmptoms first developed.
Clinical worsening
The only worsening factor is for inability to obtain appropriate clinical management. The normal course of isolated, treated polymyalgia rheumatica is for the condition to gradually resolve over 1 to 2 years. Complications from steroid treatment can arise but these are separate conditions and not worsening of the polymyalgia rheumatica.
Source URL: https://clik.dva.gov.au/ccps-medical-research-library/statements-principles/n-p/polymyalgia-rheumatica-n008-m353/rulebase-polymyalgia-rheumatica/inability-obtain-appropriate-clinical-management-polymyalgia-rheumatica