Zaccaria A, Latinakis G, Oliveri M, Maio T, Frisone G, Versace F
Struttura Complessa di Reumatologia, Ospedale San Paolo, Savona, Italia.
Reumatismo. 2009 Oct-Dec;61(4):290-7. doi: 10.4081/reumatismo.2009.290.
Polymyalgia rheumatica (PMR) is a chronic inflammatory syndrome that affects the elderly population and whose diagnosis is mainly based on clinical criteria taking little advantage of the latest innovatory methods of diagnostic imaging, for instance ultrasonography. Although it is generally characterised by increasing of inflammation values as well as pain and stiffness on the shoulder and pelvic girdles, there is a significant percentage of patients with PMR whose erythrocyte sedimentation rate (ESR) is normal; in this case to make a diagnosis is difficult. The purpose of our study is to demonstrate how useful ultrasound investigations on the shoulders joints could be in order to make a diagnosis of PMR, especially for those patients with atypical normal ESR. Our case control study included 23 patients with atypical PMR and 88 patients with standard symptomatic PMR; both groups underwent shoulder ultrasound scans before receiving steroid therapy. As it has been previously shown, the ultrasound method is able to detect distinctive aspects in the joints and tissues of the patients with PMR; so that we could find that 90% of the patients with PMR of both groups suffered from bilateral subdeltoid bursitis. This disorder is seldom found in healthy people and consequently its presence could be considered a useful diagnostic test/check for/of PMR independently from ESR values.
风湿性多肌痛（PMR）是一种影响老年人群的慢性炎症综合征，其诊断主要基于临床标准，很少利用最新的创新诊断成像方法，如超声检查。尽管它通常表现为炎症指标升高以及肩部和骨盆带疼痛和僵硬，但仍有相当比例的PMR患者红细胞沉降率（ESR）正常；在这种情况下，进行诊断很困难。我们研究的目的是证明对肩关节进行超声检查对于诊断PMR有多有用，特别是对于那些ESR非典型正常的患者。我们的病例对照研究包括23例非典型PMR患者和88例标准症状性PMR患者；两组患者在接受类固醇治疗前均接受了肩部超声扫描。正如之前所显示的，超声方法能够检测出PMR患者关节和组织中的独特特征；因此我们发现两组中90%的PMR患者患有双侧肩峰下滑囊炎。这种病症在健康人群中很少见，因此其存在可被视为一种独立于ESR值的用于PMR诊断的有用检测/检查方法。
