ADDRESS-PMR: The Diagnostic Accuracy of Ultrasound in Suspected PMR
Research type
Research Study
Full title
The use of ultrasound to improve diagnosis in patients referred with suspected polymyalgia rheumatica.
IRAS ID
132659
Contact name
Sarah Mackie
Contact email
Sponsor organisation
University of Leeds
Research summary
This study aims to develop better ways of diagnosing polymyalgia rheumatica (PMR).
PMR is a condition affecting older people, thought to be caused by inflammation in and around muscles and joints.
In suspected PMR, it is often hard to be sure about the diagnosis because there is no test that can confirm this diagnosis with certainty. Glucocorticoids usually improve symptoms within a few days. However, this treatment usually needs to continue for 2 years or more to prevent return of symptoms, and glucocorticoids may cause side-effects for many patients.
Better tests would lead to more accurate diagnosis and thus avoid unnecessary side-effects from glucocorticoids. It has been suggested that musculoskeletal ultrasound may improve accuracy of diagnosis in PMR. However, many of the findings seen in PMR can also be seen in other conditions or as part of the ageing process. This study aims to formally test the value of ultrasound, compared to the reference standard (clinical diagnosis by an expert using standard methods).
Patients with suspected PMR will be recruited from primary care and assessed in the hospital clinic. All will receive an ultrasound (patient and investigator will be blinded to the result for 2 years), and will be diagnosed and treated according to standard clinical practice. All efforts will be made to provide the best possible care for patients, within the scope of current best practice, with reference to national guidelines for diagnosis of PMR and communicating with the referring doctor as appropriate.
Little is known about long-term outcomes of patients with suspected PMR in standard clinical practice (outside research trials). We therefore plan to follow patients up in person (total 5 study visits over 2 years), and via medical records for a further 8 years, to collect data on outcomes relevant to the disease and its treatment.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
13/LO/1094
Date of REC Opinion
29 Jul 2013
REC opinion
Favourable Opinion