Akar S, Gurler O, Pozio E, Onen F, Sari I, Gerceker E, Gunes A J, Akinci B, Birlik M, Akkoc N
Division of Rheumatology, Department of Internal Medicine, School of Medicine Dokuz Eylul University, Balcova Izmir 35340, Turkey.
J Parasitol. 2007 Apr;93(2):341-4. doi: 10.1645/GE-1000R.1.
Musculoskeletal symptoms such as myalgia are well-known features in the course of trichinellosis; however, the characteristics of musculoskeletal findings have been described in detail in only 1 study. The present study was aimed to determine the joint and muscle symptoms in subjects diagnosed with acute trichinellosis at our rheumatology unit during a Trichinella britovi outbreak that occurred in Izmir, Turkey, in 2004. In total, 98 patients (55 females, 43 males; mean age 32.3 +/- 10.9 yr) were included in the study. A detailed history and full musculoskeletal examination were obtained in each patient. A self-administered questionnaire developed for recording the musculoskeletal symptoms was completed monthly until all the symptoms were resolved. Pain at the joints, restriction of movements (in shoulders, elbows, wrists, knees, ankles, and temporomandibular joints), myalgia, and muscle weakness (neck and shoulder girdle, muscles of the upper and forearm, back, thigh, and calf muscles) were assessed in every patient. Eosinophil counts, serum levels of creatine kinase, and lactate dehydrogenase also were analyzed. The most frequent musculoskeletal symptoms were muscle pain (86 cases [87.8%]), joint pain (83 [84.7%]), subjective muscle weakness (75 [76.5%]), and restriction of joint movements (63 [64.3%]). Calves, upper arm, neck and shoulder girdle, and forearms were the most affected muscle groups. Muscle pain was reported more frequently in the upper than in the lower extremities and during activity. The most frequent painful joints were shoulders, knees, wrists, and ankles. Upper extremity joints were affected more frequently than the lower extremity joints (77.6 vs. 70.4%). Joint pain occurred more frequently at rest. Both muscle weakness and restriction of joint movements were reported in and around the most frequently affected regions. No evidence of arthritis and objective muscle weakness was noted on physical examination in any patient. Musculoskeletal symptoms in the course of T. britovi infection are frequent but with an excellent prognosis. Joint pain in people suffering from acute trichinellosis may occur more frequently than reported previously.
肌痛等肌肉骨骼症状是旋毛虫病病程中的常见特征；然而，仅有1项研究详细描述了肌肉骨骼检查结果的特征。本研究旨在确定2004年在土耳其伊兹密尔发生的布氏旋毛虫疫情期间，在我们风湿科诊断为急性旋毛虫病的患者的关节和肌肉症状。本研究共纳入98例患者（55例女性，43例男性；平均年龄32.3±10.9岁）。对每位患者进行了详细的病史询问和全面的肌肉骨骼检查。每月完成一份为记录肌肉骨骼症状而设计的自填式问卷，直至所有症状消失。评估每位患者的关节疼痛、活动受限（肩部、肘部、腕部、膝部、踝部和颞下颌关节）、肌痛和肌肉无力（颈部和肩胛带、上肢和前臂肌肉、背部、大腿和小腿肌肉）。还分析了嗜酸性粒细胞计数、血清肌酸激酶和乳酸脱氢酶水平。最常见的肌肉骨骼症状是肌肉疼痛（86例[87.8%]）、关节疼痛（83例[84.7%]）、主观肌肉无力（75例[76.5%]）和关节活动受限（63例[64.3%]）。小腿、上臂、颈部和肩胛带以及前臂是受影响最严重的肌肉群。据报告，肌肉疼痛在上肢比在下肢更常见，且在活动期间更频繁。最常疼痛的关节是肩部、膝部、腕部和踝部。上肢关节比下肢关节更常受累（77.6%对70.4%）。关节疼痛在休息时更频繁出现。在最常受累区域及其周围均报告有肌肉无力和关节活动受限。体格检查未发现任何患者有关节炎和客观肌肉无力的证据。布氏旋毛虫感染过程中的肌肉骨骼症状很常见，但预后良好。急性旋毛虫病患者的关节疼痛可能比以前报告的更频繁。
