Salvarani C, Cantini F, Olivieri I, Barozzi L, Macchioni L, Niccoli L, Padula A, De Matteis M, Pavlica P
Unità Reumatologica, Azienda Ospedaliera Arciapedale S. Maria Nuova, Reggio Emilis, Italy.
Ann Intern Med. 1997 Jul 1;127(1):27-31. doi: 10.7326/0003-4819-127-1-199707010-00005.
The cause of musculoskeletal symptoms in the proximal extremities of patients who have polymyalgia rheumatica is not completely understood. The diffuse and severe discomfort can only be partially explained by the mild joint synovitis that is observed in these patients.
To determine the involvement of the synovial structures of the shoulder girdle of patients who have active symptoms of polymyalgia rheumatica.
Case-control study.
2 secondary referral centers of rheumatology.
13 case-patients who had active symptoms of polymyalgia rheumatica seen during a 6-month period, 9 control-patients who had early symptoms of elderly-onset rheumatoid arthritis, and 10 age-matched healthy controls.
Magnetic resonance imaging of the shoulder was done on the 13 case-patients, 9 control-patients, and 10 healthy controls.
The frequency of subacromial and subdeltoid bursitis was significantly higher in the case-patients (who had polymyalgia rheumatica) than in the control-patients (who had elderly-onset rheumatoid arthritis). The frequencies of synovitis of the joints and tenosynovitis of the biceps did not significantly differ between the 13 case-patients and the 9 control-patients. None of the healthy controls showed evidence of fluid accumulation in the joints, bursae, or sheaths of the long head of the biceps.
Inflammation of subacromial and subdeltoid bursae in association with synovitis of the glenohumeral joints and tenosynovitis of the biceps may contribute to the diffuse discomfort in the shoulder girdle observed in patients with polymyalgia rheumatica.
风湿性多肌痛患者近端肢体肌肉骨骼症状的病因尚未完全明确。这些患者出现的弥漫性重度不适，仅有部分可通过所观察到的轻度关节滑膜炎来解释。
确定有风湿性多肌痛活动症状患者肩带滑膜结构的受累情况。
病例对照研究。
2个二级风湿病转诊中心。
13例在6个月期间出现风湿性多肌痛活动症状的病例患者、9例有老年发病类风湿关节炎早期症状的对照患者以及10例年龄匹配的健康对照者。
对13例病例患者、9例对照患者和10例健康对照者进行肩部磁共振成像检查。
（患有风湿性多肌痛的）病例患者肩峰下和三角肌下滑囊炎的发生率显著高于（患有老年发病类风湿关节炎的）对照患者。13例病例患者和9例对照患者之间关节滑膜炎和肱二头肌腱鞘炎的发生率无显著差异。健康对照者均未显示关节、滑囊或肱二头肌长头腱鞘有积液迹象。
肩峰下和三角肌下滑囊炎症，伴发盂肱关节滑膜炎和肱二头肌腱鞘炎，可能是导致风湿性多肌痛患者肩带弥漫性不适的原因。
