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模仿纤维肌痛的常见非风湿性内科疾病:鉴别诊断的简易框架

Common Non-Rheumatic Medical Conditions Mimicking Fibromyalgia: A Simple Framework for Differential Diagnosis.

作者信息

D'Amuri Andrea, Greco Salvatore, Pagani Mauro, Presciuttini Barbara, Ciaffi Jacopo, Ursini Francesco

机构信息

General Medicine Unit, Medical Department, ASST Mantova, Ospedale Carlo Poma, Str. Lago Paiolo 10, 46100 Mantova, Italy.

Internal Medicine Unit, Medical Department, Ospedale del Delta, Via Valle Oppio 2, Lagosanto, 44023 Ferrara, Italy.

出版信息

Diagnostics (Basel). 2024 Aug 13;14(16):1758. doi: 10.3390/diagnostics14161758.

Abstract

Fibromyalgia (FM) is a chronic non-inflammatory disorder mainly characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, and a constellation of other symptoms. For this reason, delineating a clear distinction between pure FM and FM-like picture attributable to other common diseases can be extremely challenging. Physicians must identify the most significant confounders in individual patients and implement an appropriate diagnostic workflow, carefully choosing a minimal (but sufficient) set of tests to be used for identifying the most plausible diseases in the specific case. This article discusses prevalent non-rheumatological conditions commonly observed in the general population that can manifest with clinical features similar to primary FM. Given their frequent inclusion in the differential diagnosis of FM patients, the focus will be on elucidating the distinctive clinical characteristics of each condition. Additionally, the most cost-effective and efficient diagnostic methodologies for accurately discerning these conditions will be examined.

摘要

纤维肌痛(FM)是一种慢性非炎症性疾病,主要特征为广泛的肌肉骨骼疼痛、疲劳、睡眠障碍以及一系列其他症状。因此,明确区分单纯性FM和由其他常见疾病引起的FM样症状极具挑战性。医生必须识别个体患者中最主要的混杂因素,并实施适当的诊断流程,谨慎选择一套最少(但足够)的检查项目,以用于在特定病例中识别最可能的疾病。本文讨论了普通人群中常见的非风湿性疾病,这些疾病可能表现出与原发性FM相似的临床特征。鉴于它们经常被纳入FM患者的鉴别诊断中,重点将放在阐明每种疾病独特的临床特征上。此外,还将研究用于准确辨别这些疾病的最具成本效益和效率的诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/089c/11354086/cd97f78da5f8/diagnostics-14-01758-g001.jpg

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