Healey L A
University of Washington School of Medicine, Seattle.
Clin Geriatr Med. 1988 May;4(2):323-31.
Polymyalgia rheumatica and temporal arteritis are common syndromes of unknown cause that afflict older patients, the great majority of whom are white. Polymyalgia, which is seen more frequently, is a benign synovitis and can be differentiated from rheumatoid arthritis by the distribution of inflamed joints and by its rapid and complete response to small doses of prednisone. Temporal or giant cell arteritis occurs in approximately 20 per cent of patients with polymyalgia rheumatica and may present with either localized or systemic symptoms. Once the diagnosis is confirmed by temporal artery biopsy, patients should be treated with a large dose of prednisone for at least 1 month. The erythrocyte sedimentation rate is a useful test in suspecting the diagnosis initially, but is a poor gauge to tapering the steroid dose.
风湿性多肌痛和颞动脉炎是病因不明的常见综合征，多见于老年患者，其中绝大多数为白人。风湿性多肌痛更为常见，是一种良性滑膜炎，可通过受累关节的分布以及对小剂量泼尼松的快速、完全反应与类风湿关节炎相鉴别。颞动脉炎或巨细胞动脉炎约见于20%的风湿性多肌痛患者，可表现为局部或全身症状。一旦经颞动脉活检确诊，患者应接受大剂量泼尼松治疗至少1个月。红细胞沉降率在初步怀疑诊断时是一项有用的检查，但在调整类固醇剂量方面作用不佳。
