Moosig Frank, Holle Julia U
Dtsch Med Wochenschr. 2024 Sep;149(19):1163-1173. doi: 10.1055/a-2329-6673. Epub 2024 Sep 9.
Pain in the musculoskeletal system and therefore joint pain is one of the most common reasons for consulting a general practitioner (GP). Inflammatory rheumatic diseases are among the important differential diagnoses. However, the prevalence of rheumatological diseases is significantly lower than that of degenerative causes of pain. Incorrect referrals can be avoided if the causes of pain are better differentiated in GP practices. This article presents the first differential diagnostic steps that make it easier for the GP to make further treatment decisions. Physical examination, laboratory diagnostics and imaging are discussed, and the concept of "clinically suspect arthralgia" as well as the possible effects of treatment trials with glucocorticoids are presented.
肌肉骨骼系统疼痛，进而关节疼痛，是患者咨询全科医生（GP）的最常见原因之一。炎性风湿性疾病是重要的鉴别诊断病种。然而，风湿性疾病的患病率明显低于疼痛的退行性病因。如果在全科医生诊所能更好地鉴别疼痛原因，就可以避免不正确的转诊。本文介绍了初步鉴别诊断步骤，便于全科医生做出进一步的治疗决策。文中讨论了体格检查、实验室诊断和影像学检查，并介绍了“临床疑似关节痛”的概念以及糖皮质激素治疗试验可能产生的影响。
