Cantini F, Salvarani C, Olivieri I, Niccoli L, Padula A, Bellandi F, Palchetti R
Unità Reumatologica, II Divisione di Medicina Interna, Ospedale di Prato, Italy.
Clin Exp Rheumatol. 1998 May-Jun;16(3):305-8.
Patients are said to have inflammatory spinal pain if they fulfill at presentation 4 of the following 5 criteria: duration of spinal discomfort for at least 3 months, spinal morning stiffness, age less than 40, insidious onset of symptoms, and no relief from pain with rest, but improvement with exercise. Inflammatory spinal pain is typical of the spondylarthropathies. Only in a minority of the cases it is found in other rheumatic disorders such as rheumatoid arthritis, fibromyalgia or infectious spondyilitis. Tuberculous spondylitis is rarely mentioned as a possible cause of inflammatory spinal pain. We describe 4 patients with tuberculous spondylitis seen over a 3-year period who met the clinical criteria for inflammatory spinal pain at presentation. We conclude that inflammatory spinal pain may be a presenting feature, albeit rare, of tuberculous spondylitis. Awareness of this finding should help facilitate the proper diagnosis and the institution of appropriate therapy.
如果患者在就诊时符合以下5项标准中的4项，就被认为患有炎性脊柱疼痛：脊柱不适持续至少3个月、脊柱晨僵、年龄小于40岁、症状隐匿起病、休息不能缓解疼痛但运动后改善。炎性脊柱疼痛是脊柱关节病的典型症状。只有少数情况下，它见于其他风湿性疾病，如类风湿关节炎、纤维肌痛或感染性脊柱炎。结核性脊柱炎很少被提及为炎性脊柱疼痛的可能病因。我们描述了3年内见到的4例结核性脊柱炎患者，他们在就诊时符合炎性脊柱疼痛的临床标准。我们得出结论，炎性脊柱疼痛可能是结核性脊柱炎的一个表现特征，尽管很少见。认识到这一发现应有助于促进正确诊断和采取适当治疗。
