•Cases where the diagnosis is unclear.
• Where suspicion exists regarding a concomitant inflammatory condition such as polymyalgia rheumatica or rheumatoid arthritis.
•Patients that are having inadequate symptom control despite treatment.
•Patients with complicated medical co-morbidities precluding standard treatments.
•Cases that might benefit from injection-type therapies and the primary care provider is not comfortable providing these therapies.
•Those patients where surgery is indicated.