Doctors' confusion over diagnosis: Questions they should ask

@dadcue can you make a contribution?

@lmz i copied DadCue because he has had PMR for years. I think your list is great. I have RA and there is significant overlap of symptoms with PMR.
Do you never have hand weakness? When mine started I thought it was carpal tunnel because my hands were numb and painful and so weak I couldn’t squeeze shampoo out of the bottle.
Thats the only symptom I don't see referenced. …

Great questions but I'm not sure how these questions lead to a definitive diagnosis. The following link written in 2014 speaks to the difficulty of diagnosing PMR. I don't think anything has changed in ten years except more research has been done specifically with biologic therapy.

"One of the challenges in the diagnosis of PMR is the lack of any diagnostic tests that are specific for this entity. Additionally, given the multitude of other conditions that can mimic this diagnosis or present with polymyalgic symptoms, the diagnosis requires exclusion of other conditions."

The conclusion is spot on ...

Conclusion
PMR is a common inflammatory condition affecting individuals aged 50 years and over. There is a close association between PMR and GCA. Given the absence of any diagnostic tests specific to PMR, careful consideration should be given to excluding other mimics, particularly SpA and RA. Ultrasonography of affected joints may complement the clinical evaluation for the diagnosis of PMR. Treatment consists of prolonged GC therapy, but relapses are common. Moreover, GCs are associated with significant morbidity. Evaluation of therapies targeting inflammatory cytokines as alternatives to GCs in PMR is underway.

Well thought out suggestions for a history and inventory of symptoms. Onset of the first symptoms and any possible inciting conditions are also of interest.
Family history with PMR in my mother was important
in my case. I payed out of pocket to check IL-6 level at
a reference lab to consider therapy options.
There is no test or perfect screening algorithm for PMR.
It can take time for patient and physician to arrive at
the diagnosis with an outlier that has an atypical course.
Response to an adequate dose of steroid remains an
important point in diagnosis.

Mayo also screened me for cancer with PET scan. Appears some cancers can produce the same symptoms. Might have been due to prior prostate cancer but one of questions was concerning family history.

I thought two of the main requirements for a diagnosis of PMR are that the pain is bilateral, on both sides of the body, and that onset is sudden and acute. The questions should probably mention those?

I think you will find plenty of responses the pain started in one place or another leading them to incorrect assumption of diagnosis. I pursued a right shoulder issue with my orthopedic. As I was pursuing the issue it moved to both shoulders. I think eventually a bilateral issue comes into play.

That's interesting. I woke up one morning unable to move with the pain, with no previous symptoms. My doctor said the sudden onset, bilateral presentation and severity were the main reasons for the diagnosis.

It will be interesting to see how AI handles the diagnosis.
Will it over diagnose, misdiagnose or hedge its bets.
A good physician learns how to say” I don’t know.”

You got lucky. Right. I completely agree it moves bilateral. Just took me a couple of months before I couldn't move anything.

Same for RA