Department of Rheumatology and Rehabilitation Barking, Havering and Redbridge University Hospitals NHS Trust, King George Hospital, Essex, UK.
Clin Exp Rheumatol. 2012 Nov-Dec;30(6 Suppl 74):24-30. Epub 2012 Dec 14.
To assess the extent of coexistence of inflammatory back pain (IBP) with fibromyalgia (FM) features in patients with spondyloarthritis (SpA), and to assess the degree of overlap of FM tender points (TeP) and enthesitis sites (ES) in patients with SpA.
We evaluated 61 consecutive patients who presented with IBP. Anterior and posterior anatomic diagrams were used as an aid to record assessments of TeP typically seen in FM and ES.
Of the patients assessed (n=61), 60 patients (97.9%) fulfilled criteria for IBP (male: female=17:43 (28.3%:71.7%); mean age=47.9 years (SD=11.5) and were included in the analysis. Of those who returned the questionnaire (n=47 (78.3%), 76.6% had onset of symptoms at ≤40 years (mean age=33.5±12.5 years), 87.2% had back pain of ≥3 months duration, 91.5% had morning stiffness (mean duration=70±66 minutes), and 60% showed improvement of pain with exercise. Eating disorders were reported by 21.3% of subjects, and stress was identified as a disease trigger by 40.4% of the respondents. Other symptoms related to FM were reported by 68.1% of the interviewed subjects. Of the 60 patients assessed, 18 (30%) fulfilled the clinical criteria for FM (at least 11 out of 18 TeP). Using regression analysis, a significant correlation was identified between FM TeP and ES.
One third of patients with IBP fulfilled the criteria for FM. There is a significant degree of overlap between FM TeP and ES in patients with IBP.
评估强直性脊柱炎（SpA）患者中炎症性背痛（IBP）与纤维肌痛（FM）特征共存的程度，并评估 SpA 患者 FM 压痛（TeP）和附着点炎（ES）的重叠程度。
我们评估了 61 例出现 IBP 的连续患者。使用前后解剖图来帮助记录通常在 FM 中看到的 TeP 和 ES 评估。
评估的患者（n=61）中，60 例（97.9%）符合 IBP 标准（男性：女性=17:43（28.3%：71.7%）；平均年龄=47.9 岁（SD=11.5），并纳入分析。在返回问卷的患者中（n=47（78.3%），76.6%的患者在≤40 岁时出现症状（平均年龄=33.5±12.5 岁），87.2%的患者背痛持续≥3 个月，91.5%的患者有晨僵（平均持续时间=70±66 分钟），60%的患者运动后疼痛改善。21.3%的患者报告有饮食障碍，40.4%的患者认为压力是疾病的诱因。接受采访的患者中有 68.1%报告了其他与 FM 相关的症状。在评估的 60 例患者中，18 例（30%）符合 FM 的临床标准（至少有 18 个 TeP 中的 11 个）。使用回归分析，确定 FM TeP 与 ES 之间存在显著相关性。
三分之一的 IBP 患者符合 FM 标准。在 IBP 患者中，FM TeP 和 ES 之间存在显著的重叠程度。
