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This is a very important question and needs more scientific research. I have seen 5 different rheumatologists (R) during my 35 years with PMR. The first R based on my discription of my pain which seemingly came out of a text book that I never read. prescribed prednisone (P) which solved my pain in 6 hours that I had for years. The second R said I was doing so well on P that he would not change anything. The third R, unbelievably, examined me for one hour and 40 minutes one on one and after that time he said to me, "I don't think you have PMR, but I do not know what you have." The 4th R basically said the same thing that the second R said. The 5th and current R didn't think I had PMR because I was first diagnosed in my 40s when PMR is a disease of 50 and over. He tried various other drugs other than P and none worked. I am now on Kevzara but could not get below 2.5 mg P a day.
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@jfannarbor
Maybe you should stick with the rhematologist that you like the best. Having too many opinions is just as bad as not having any opinion about a diagnosis.
I think being in your 40's "might exclude" PMR back then. However, age wouldn't exclude the diagnosis of PMR later on. There are plenty of other autoimmune conditions that feel like PMR when you are younger. I had symptoms similar to PMR in my early 30s. I was diagnosed with another autoimmune condition back then. My first dose of prednisone was approximately 40 years ago.
I waited until I was 52 to be diagnosed with PMR even though my symptoms hadn't changed that much. I "self medicated" for 20 years before PMR was diagnosed. However, Prednisone was prescribed to me in massive amounts by an opthalmologist for uveitis but not necessarily for other things.
My wife disputed how much I self medicated with prednisone. She made an appointment for me to see her primary care doctor when I needed help getting out of bed and dressed. She decided to go with me to the appointment so I wouldn't leave out any details.
I eventually got a "consensus opinion" from three rheumatologists at one visit when I was diagnosed with PMR. My PMR diagnosis was in addition to some other autoimmune conditions. I didn't know what PMR was back then. When there were three rheumatolgists together in one room, I told them that my only problem was that I ran out of prednisone! Otherwise, I didn't think I needed a rheumatologist.
Some genetic testing might be a good idea for you. I was fortunate that a doctor did a genetic test on me 40 years ago. At the time genetic testing wasn't readily available and it was expensive. The doctor said a genetic test wouldn't solve the problem or dictate how I would be treated in the future.
The genetic test was positive for HLA-B27. That predisposed me to a whole slew of rheumatology disorders but not a single definitive diagnosis.
https://www.ncbi.nlm.nih.gov/books/NBK551523/