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Polymyalgia Rheumatica N008

Last amended 
10 December 2019
Current RMA Instruments:
Reasonable Hypothesis SOP
19 of 2016
Balance of Probabilities SOP
20 of 2016
Changes from previous Instruments:

SOP Bulletin 188

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.