Zih Francis Si Wai, Da Costa Deborah, Fitzcharles Mary-Ann
Division of Rheumatology and McGill Pain Centre, Department of Medicine, Montreal General Hospital, McGill University Health Centre, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4, Canada.
J Rheumatol. 2004 Dec;31(12):2468-71.
To examine the benefit of specialist rheumatology consultation and followup for the first 238 patients referred to a tertiary care fibromyalgia (FM) clinic with emphasis on final diagnosis and outcome.
A retrospective chart review was performed for the first 238 patients attending a rheumatology subspecialty FM clinic. The main variables of interest were management received at the clinic, final diagnosis, and outcome.
The final diagnosis was FM in 68%, and some other condition in the remaining 32%. Specialist contact was identified as useful in 73% of the total patient group, 96 with FM and 74 with non-FM. In the patients with FM who received followup in the clinic, outcome was judged favorable in 54%, whereas 46% showed no change or decline in health status.
An important value of specialist rheumatology contact for patients with a symptom suggestive of diffuse musculoskeletal pain is to ensure that some other potentially treatable condition is not overlooked, rather than the provision of ongoing care for those with FM. Continued followup in a specialist clinic for patients with a primary diagnosis of FM is of questionable benefit.
研究为转诊至三级医疗纤维肌痛（FM）诊所的前238例患者提供专科风湿病咨询及随访的益处，重点关注最终诊断和结局。
对在风湿病亚专科FM诊所就诊的前238例患者进行回顾性病历审查。主要关注的变量为在诊所接受的治疗、最终诊断和结局。
最终诊断为FM的患者占68%，其余32%为其他疾病。在全部患者组中，73%的患者认为专科会诊有用，其中FM患者96例，非FM患者74例。在诊所接受随访的FM患者中，54%的患者结局良好，而46%的患者健康状况无变化或恶化。
对于有弥漫性肌肉骨骼疼痛症状的患者，专科风湿病会诊的重要价值在于确保不忽视其他潜在可治疗的疾病，而非为FM患者提供持续治疗。对初步诊断为FM的患者在专科诊所进行持续随访的益处存疑。
