#5-85E. Ruling Out PMR: The Diagnostic Accuracy of Musculoskeletal Ultrasound (Lancet Rheumatol, 2026)

How accurate is musculoskeletal ultrasound for diagnosing polymyalgia rheumatica in daily clinical practice? In two multicenter cohorts of glucocorticoid-naive patients with suspected polymyalgia rheumatica, shoulder and hip ultrasound showed high diagnostic sensitivity, indicating that the absence of inflammatory lesions reliably rules out non-inflammatory mimicking conditions. However, clinicians must consider potential incorporation bias, as ultrasound findings informed the final clinical diagnosis. Ultimately, ultrasound serves clinicians primarily as an adjunctive rule-out tool to prevent unnecessary steroid therapy, rather than a standalone rule-in test.

Citation: Våben CS, Nielsen AW, Sandovici M, Kjær SG, Hansen IT, Blegvad-Nissen J, et al. Diagnostic accuracy of musculoskeletal ultrasound in suspected polymyalgia rheumatica: a multicentre, cohort study. Lancet Rheumatol. 2026;8:e776-87.

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