Ali Muhammad Armughan, Rehman Marium, Saeed Mohammad
Medical Student, Dow University of Health Sciences, Karachi.
Consultant Rheumatologist, Musculoskeletal Ultrasound Specialist, Medlife Clinic, Karachi.
J Coll Physicians Surg Pak. 2017 Sep;27(9):S134-S136.
Symptoms of inflammatory arthritis such as rheumatoid arthritis (RA) can overlap with fibromyalgia syndrome (FMS). Moreover, FMS and RAcan coexist. Hence, the diagnosis of low intensity, antibody-negative RAmay present a challenge. Here, we present the case of a middle-aged woman thought to have FMS, osteoarthritis and osteoporosis for 4 years prior to being diagnosed as seronegative RAon musculoskeletal ultrasound (MSKUS). Targeted therapy with etanercept led to a complete clinical response and normalization of previously elevated C-reactive protein. We conclude that MSKUS is a sensitive tool for distinguishing low-intensity inflammatory arthritis from FMS with important clinical consequences.
类风湿性关节炎（RA）等炎性关节炎的症状可能与纤维肌痛综合征（FMS）重叠。此外，FMS和RA可能共存。因此，诊断低强度、抗体阴性的RA可能具有挑战性。在此，我们报告一例中年女性病例，该患者在通过肌肉骨骼超声（MSKUS）被诊断为血清阴性RA之前，被认为患有FMS、骨关节炎和骨质疏松症4年。使用依那西普进行靶向治疗导致临床完全缓解，且先前升高的C反应蛋白恢复正常。我们得出结论，MSKUS是区分低强度炎性关节炎和FMS的敏感工具，具有重要的临床意义。
