Sperotto Francesca, Brachi Sara, Vittadello Fabio, Zulian Francesco
Department of Pediatrics, University of Padua, Padua, Italy.
Pediatr Rheumatol Online J. 2015 May 15;13:16. doi: 10.1186/s12969-015-0014-z.
Chronic Musculoskeletal Pain (MSP) in children can be due to non-inflammatory conditions, such as the benign joint hypermobility syndrome (BJHS) or idiopathic MSP (IMSP). Aim of the study was to evaluate type and persistence of MSP in a cohort of schoolchildren with MSP followed for 3 years, in order to identify the main risk factors.
Healthy schoolchildren, aged 8-13 years, underwent a general and rheumatologic examination, focusing on presence of chronic MSP, defined as continuous or recurrent pain lasting more than 3 months and heavily interfering with daily life activities, presence of generalized joint hypermobility, the body mass index and the pubertal stage. All symptomatic subjects were re-evaluated 3 years later with the same methods.
Seventy of the 88 symptomatic subjects of the initial cohort of 289 were re-evaluated 3 years later. Of these, 38 (54.3 %) still presented MSP, including 19 with BJHS and 19 with IMSP. Main symptoms were lower limbs arthralgia and myalgia. MSP persisted more in females than in males (p = 0.038) and in pubertal rather than pre-pubertal subjects (p = 0.022); these subjects recovered significantly more both from BJHS (p = 0.004) and IMSP (p = 0.016). Gender did not influence the distribution of MSP according to pubertal stage.
Female gender, BJHS and pubertal stage are important risk factors for persistence of MSP. Further studies are needed to evaluate the natural history of MSP towards adulthood and the role of the pubertal age.
儿童慢性肌肉骨骼疼痛（MSP）可能由非炎症性疾病引起，如良性关节活动过度综合征（BJHS）或特发性MSP（IMSP）。本研究的目的是评估一组患有MSP的学龄儿童在随访3年期间MSP的类型和持续性，以确定主要风险因素。
对8-13岁的健康学龄儿童进行全面的体格检查和风湿病检查，重点关注慢性MSP的存在，慢性MSP定义为持续或反复疼痛超过3个月且严重干扰日常生活活动，检查是否存在全身关节活动过度、体重指数和青春期阶段。所有有症状的受试者在3年后用相同方法重新评估。
最初289名受试者队列中的88名有症状受试者中有70名在3年后接受了重新评估。其中，38名（54.3%）仍有MSP，包括19名患有BJHS和19名患有IMSP。主要症状为下肢关节痛和肌痛。MSP在女性中比男性持续时间更长（p = 0.038），在青春期受试者中比青春期前受试者持续时间更长（p = 0.022）；这些受试者从BJHS（p = 0.004）和IMSP（p = 0.016）中恢复得明显更多。性别不影响MSP根据青春期阶段的分布。
女性、BJHS和青春期阶段是MSP持续存在的重要风险因素。需要进一步研究来评估MSP到成年期的自然病程以及青春期年龄的作用。
