Ameer Faisal, McNeil Julian
FRACP, Senior Advanced Trainee Registrar, Thoracic Medicine, Royal Adelaide Hospital, and Clinical Associate Lecturer, Discipline of Medicine, University of Adelaide, SA.
Aust Fam Physician. 2014 Jun;43(6):373-6.
Polymyalgia rheumatica is a relatively common inflammatory rheumatic disease. There are no validated international guidelines available for the diagnosis and treatment of PMR; however, diagnostic and classification criteria are currently being developed.
The aim of this article is to summarise the main management options suggested by American College of Rheumatology and discusses the role of the general practitioner in the diagnosis and early management of PMR.
Diagnosis is made on the basis of a combination of clinical and laboratory findings. Patients typically present with shoulder and hip girdle pain with pronounced stiffness. Inflammatory markers are usually elevated and an ultrasound and MRI of the shoulder and hip can be done to localise inflamed tissues. Response to steroids should not be used as a defining feature of PMR but treatment with low dose prednisone should be considered. PMR has an excellent prognosis if diagnosis is prompt and therapy adequate.
风湿性多肌痛是一种相对常见的炎性风湿性疾病。目前尚无经过验证的国际指南可用于风湿性多肌痛的诊断和治疗；然而，诊断和分类标准正在制定中。
本文旨在总结美国风湿病学会建议的主要管理方案，并讨论全科医生在风湿性多肌痛的诊断和早期管理中的作用。
诊断基于临床和实验室检查结果的综合判断。患者通常表现为肩部和骨盆带疼痛，并伴有明显的僵硬感。炎症标志物通常会升高，可以进行肩部和髋部的超声及磁共振成像检查以定位发炎组织。不应将对类固醇的反应作为风湿性多肌痛的决定性特征，但应考虑使用低剂量泼尼松进行治疗。如果诊断及时且治疗充分，风湿性多肌痛的预后良好。
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