New guidelines are a step forward, but many unanswered questions remain Evidence is lacking on the management of polymyalgia rheumatica.1 The recent guidelines published by the British Society for Rheumatology (BSR) and the British Health Professionals in Rheumatology (BHPR) are a brave attempt to give some structure to the diagnosis and treatment of this condition.2 Polymyalgia rheumatica is one of the most common inflammatory rheumatic diseases in elderly people. It is characterised by pain and stiffness, usually of sudden onset, affecting the limb girdle areas (shoulder and hip), neck, and torso.3 Its prevalence in people aged over 50 is about 700 per 100 000.4 It has many non-specific features and a wide differential diagnosis. No “gold standard” diagnostic test is available, so the diagnosis is often made on clinical grounds. This can lead to diagnostic error. Polymyalgia rheumatica is managed mainly in …