Salet A, Haanen H C
St. Antonius Ziekenhuis, afd. Interne Geneeskunde en Reumatologie, Nieuwegein.
Ned Tijdschr Geneeskd. 1995 Apr 8;139(14):727-30.
To determine the characteristics and the course of chronic arthralgia (CA) and the differences from newly diagnosed rheumatoid arthritis (RA).
Retrospective, with a follow up after 2.5 years.
Outpatient clinic for rheumatology of the St. Antonius Hospital, Nieuwegein, The Netherlands.
The diagnosis of CA was made in the period of June 1986-December 1988 in 74 patients. The CA patients were sent a questionnaire after a mean of 2.5 years and invited for another rheumatological examination; 62 patients responded (84%). Data were compared with all 52 RA patients newly diagnosed in the same period by the same specialist.
At the first visit CA had been present for 1 year, RA patients had had complaints for 0.6 years (p = 0.02). The RA patients had elevated BSE rates more often (31 vs. 8 mm in CA) (p < 0.0001) and more serious morning stiffness (75 vs. 0 minutes in CA) (p < 0.0001). The diagnosis of RA was made at the first visit in 86% and in 96% within half a year later. None of the CA patients developed an inflammatory joint disease within 2.5 years. In 1 out of 3 CA patients the diagnosis of fibromyalgia was made and more than 50% had complaints.
CA for more than 3 years does not predict inflammatory rheumatic disease. In contrast, RA develops in a short period and the diagnosis is made in 96% within 1 year. CA can be considered a feature of the fibromyalgia syndrome.
确定慢性关节痛（CA）的特征、病程及其与新诊断类风湿关节炎（RA）的差异。
回顾性研究，随访2.5年。
荷兰新韦根圣安东尼医院风湿病门诊。
1986年6月至1988年12月期间，74例患者被诊断为CA。平均2.5年后，向CA患者发送问卷，并邀请其再次进行风湿病检查；62例患者回复（84%）。将数据与同期由同一位专科医生新诊断的52例RA患者进行比较。
首次就诊时，CA已存在1年，RA患者有症状0.6年（p = 0.02）。RA患者血沉升高更常见（CA组为8 mm，RA组为31 mm）（p < 0.0001），晨僵更严重（CA组为0分钟，RA组为75分钟）（p < 0.0001）。86%的RA患者在首次就诊时被诊断，96%在半年内被诊断。2.5年内，无CA患者发展为炎性关节病。3例CA患者中有1例被诊断为纤维肌痛，超过50%有症状。
超过3年的CA不能预测炎性风湿性疾病。相比之下，RA在短时间内发病，96%在1年内被诊断。CA可被视为纤维肌痛综合征的一个特征。
