Vecchio P
Princess Alexandra Hospital, Brisbane.
Aust Fam Physician. 1998 Jan-Feb;27(1-2):17-20.
The term arthritis is not specific enough to be regarded as a diagnosis. Many patients believe any joint pain is due to 'arthritis' but their understanding of the term can be very vague.
It is important to have a working protocol when a patient presents with aching joints. This article draws attention to the variety of possibilities that may underly the patient's symptoms.
A variety of local and systemic causes may explain pain in one or more joints. Differentiating these requires a thorough and purposeful history. Eliciting certain features such as the presence of stiffness, the occurrence of night pain or associated features such as fever or weight loss help differentiate underlying pathology. In older people it is important to bear in mind the possibility of polymyalgia rheumatica. By considering the range of possibilities, the practitioner is less likely to be fooled by the mimics.
“关节炎”一词不够具体,不能被视为一种诊断。许多患者认为任何关节疼痛都是由“关节炎”引起的,但他们对这个词的理解可能非常模糊。
当患者出现关节疼痛时,制定一个可行的方案很重要。本文提请注意可能导致患者症状的各种可能性。
多种局部和全身原因可能解释一个或多个关节的疼痛。区分这些原因需要全面且有针对性的病史询问。引出某些特征,如僵硬的存在、夜间疼痛的发生或相关特征,如发热或体重减轻,有助于区分潜在的病理情况。在老年人中,要牢记风湿性多肌痛的可能性。通过考虑各种可能性,从业者不太可能被类似症状所误导。