Salvarani C, Hunder G G
Reggio Emilia, Italy.
Arthritis Rheum. 1999 Jun;42(6):1259-66. doi: 10.1002/1529-0131(199906)42:6<1259::AID-ANR24>3.0.CO;2-I.
To define musculoskeletal manifestations occurring in a population-based cohort of patients with giant cell (temporal) arteritis (GCA).
The records of 128 patients with GCA diagnosed over a 42-year-period (1950-1991) in Olmsted County, MN, were reviewed for the presence and type of musculoskeletal manifestations, their relationship to the onset and course of GCA, and their response to treatment.
Fifty-three patients (41%) developed polymyalgia rheumatica: 23 before, 17 concurrently with, and 13 after the diagnosis of GCA. Thirty patients (23%) developed 1 or more peripheral musculoskeletal manifestations. These included peripheral synovitis in 23 patients (6 of whom fulfilled criteria for rheumatoid arthritis), distal extremity swelling with pitting edema in 13, distal swelling without pitting in 5, tenosynovitis in 6, and carpal tunnel syndrome in 2. Fifty-seven episodes of peripheral manifestations occurred in the 30 patients at different times during the course of GCA. In most, the onset of PMR and peripheral manifestations was within 2 years of the diagnosis of GCA.
Musculoskeletal symptoms in GCA are common and varied. Most appear linked temporally to the underlying GCA, indicating that the nature of this illness and its clinical expression are broader than often considered.
明确在以人群为基础的巨细胞（颞）动脉炎（GCA）患者队列中出现的肌肉骨骼表现。
回顾了明尼苏达州奥尔姆斯特德县在42年期间（1950 - 1991年）诊断的128例GCA患者的记录，以了解肌肉骨骼表现的存在情况和类型、它们与GCA发病及病程的关系以及对治疗的反应。
53例患者（41%）出现了风湿性多肌痛：23例在GCA诊断之前，17例与GCA诊断同时出现，13例在GCA诊断之后。30例患者（23%）出现了1种或更多种外周肌肉骨骼表现。其中包括23例患者出现外周滑膜炎（其中6例符合类风湿关节炎标准），13例出现伴有凹陷性水肿的远端肢体肿胀，5例出现无凹陷的远端肿胀，6例出现腱鞘炎，2例出现腕管综合征。在30例患者中，外周表现在GCA病程中的不同时间出现了57次发作。大多数情况下，风湿性多肌痛和外周表现的发作在GCA诊断后的2年内。
GCA中的肌肉骨骼症状常见且多样。大多数症状在时间上似乎与潜在的GCA相关，这表明这种疾病的性质及其临床表现比通常认为的更为广泛。
