Can ultrasound help confirm PMR diagnosis?

Apparently ultrasound is "useful" but not a definitive test.
https://ard.bmj.com/content/83/Suppl_1/1989.2

It is helpful for inflammation around joints and now useful for diagnosing Giant Cell arteritis. Suggested areas are cranial, axillary and aortic arteries for screening. My cardiologist included carotid ultrasound to evaluate my risks with systemic inflammatory disease.

just an FYI _ There obviously is (growing?) interest in this approach to PMR :
https://cpd.partners.org/content/2025-update-vasculitis-and-polymyalgia-rheumatica-vasculitis-ultrasound-workshop.
Mark Matza is an up and coming (shall we say ?) Rheumatologist / clinical researcher here is Boston area along with Sebastian Unizony .
Here are two of the topics in the workshop
Current Treatment of Giant Cell Arteritis: IL-6 Blockade and Beyond | John H. Stone, MD, MPH

What is the Role of Biologics and Other Glucocorticoid-Sparing Agents in the Treatment of Polymyalgia Rheumatica | Sebastian Unizony, MD

I have appreciated the following point of view that is talked about in the following link.
https://www.healio.com/news/rheumatology/20201012/moving-away-from-failed-prednisone-to-il6-blockade-in-giant-cell-arteritis
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I asked myself over and over again why it took me so long to taper off Prednisone until Actemra was tried. Then certain people (self proclaimed experts not everyone) on another PMR forum criticized my doctor for treating me with Actemra instead of Prednisone. The experts said Prednisone was the "only option."

There were several "failed" steroid sparing medications that were started and were only given one chance at preventing my flares of PMR. Why was Prednisone given countless attempts to achieve remission of PMR and it was never said to have "failed?" It was said that I tapered off too quickly as if it was my fault for tapering incorrectly.

I totally agree with you. I am back up to 20 mg of prednisone after "failing to taper" for the 3rd time. My symptoms seem to be PMR for sure, but the pred isn't working.
Thanks so much for all your widsom. You're my favorite contributor!
I'm going to ask for ultrasounds and Actemra when I talk to my rheumatologist tomorrow. I've tried hydroxycloroquine and leflunomide, and neither worked.

You might want to mention Kevzara for PMR because it is FDA approved for PMR. Actemra still isn't FDA approved for PMR but it is for GCA.

When I was started on Actemra, my rheumatologist was excited about the GIACTA trial for GCA. He had to get authorization for me to get Actemra. There were some exceptions made for me in part because I had multiple autoimmune conditions. You may need to try methotrexate first because that was one criteria why Actemra was approved for me.

Things are rapidly changing in the realm of PMR/GCA. I think IL-6 levels, ultrasounds and the search for alternatives to Prednisone are all steps in the right direction. I hope your doctor will be receptive to your suggestions.

where do you live @spiker if you don't mind me asking. I think there is still enrollment in Novartis IL17 trials . Or some other clinical trial or study that might be out there. My friend's rheumatologist had doses of Kevzara for him " to try" . I hope you have enough time in your appointment to discuss all you wish to .

I guess depending on your relationship with your rheumatologist , you can ask what he/she thinks of this figure in this paper that shows the responses of PMR patients . Also, I never could get a word in , but I wanted to her to tell me how her other PMR patients were doing : ( - I call this to your attention because not only does this forum allow you to share and discuss PMR -progress, the image of the graphed data was enlightening to me. SO - turns out I was a " rapid responder and in sustained recovery " I tapered from 30 mg to ( May 2023) to zero Sept 2024. No return of active disease , fingers crossed !
But , however you are responding , you are not alone ! : )

There are other conditions that evidently mimic PMR, and may or may not respond to prednisone. Suggest you search this forum using keyword “mimic” to discover links to information that might be relevant to your situation. All pain is not PMR !

Thank you. Rheumatologist and I are trying to figure out other causes, but keep ruling them out…..

Thank you, I appreciate the additional info! I am near Detroit.