临床误诊误治2024，Vol.37Issue(3)：5-8,4.DOI:10.3969/j.issn.1002-3429.2024.03.002
风湿性多肌痛误诊为类风湿关节炎六例临床分析
Clinical Analysis of 6 Patients with Polymyalgia Rheumatica Misdiagnosed as Rheumatoid Arthritis
摘要
Abstract
Objective To investigate the clinical characteristics,causes of misdiagnosis and preventive measures of polymyalgia rheumatica(PMR).Methods Clinical data of 6 PMR patients misdiagnosed with rheumatoid arthritis(RA)from March 2020 to March 2023 were retrospectively analyzed.Results In this group,4 patients had multiple mild periph-eral joint pain without inducement lasting from 1 month to 1.5 years,and the pain worsened for 3 days.In this group,2 pa-tients had stiff shoulder and neck muscles,joint pain and fever symptoms.All the 6 patients were misdiagnosed as RA,and the duration of misdiagnosis was 9 d-6 months.Corresponding treatment was far from satisfactory.Further relevant examination was performed,and MRI showed that the patient had no invasive or destructive lesions in the pain area,the anti-cyclic citrul-line peptide antibody was negative,and the treatment with low-dose glucocorticoid was effective.After inquiring about the fam-ily history in detail,combined with the characteristics of the pain site and the examination and test results,the final diagnosis of PMR was made.They were given low-dose glucocorticoid combined with non-steroidal anti-inflammatory drugs or different immunosuppressant treatment,and after the symptoms disappeared,the dosage was reduced to maintain treatment,showing fa-vorable effect.Conclusion PMR is more likely to be misdiagnosed as RA due to its diverse clinical manifestations and lack of specific test indicators.Clinicians should strengthen the ability of differential diagnosis of PMR,perform relevant examina-tion in time,and reduce the misdiagnosis or missed diagnosis of PMR.关键词
风湿性多肌痛/误诊/关节炎,类风湿/关节痛/发热/糖皮质激素类/免疫抑制剂/抗环瓜氨酸肽抗体Key words
Polymyalgia rheumatica/Misdiagnosis/Arthritis,rheumatoid/Arthralgia/Fever/Glucocorticoids/Im-munosuppressive agents/Anti-cyclic peptide containing citrulline antibody分类
医药卫生引用本文复制引用
李岚,焦付达,赵金梅..风湿性多肌痛误诊为类风湿关节炎六例临床分析[J].临床误诊误治,2024,37(3):5-8,4.基金项目
秦皇岛市科学技术局项目(202301A060) （202301A060）
