Polymyalgia rheumatica
Резюме
Определение
Анамнез и осмотр
Ключевые диагностические факторы
- shoulder/hip girdle stiffness
- shoulder/hip girdle pain
- rapid response to corticosteroids
Другие диагностические факторы
- acute onset
- low-grade fever
- anorexia
- weight loss
- malaise
- depression
- asthenia
- oligoarticular arthritis
Факторы риска
- age ≥50 years
- giant cell arteritis (GCA)
- female sex
Диагностические исследования
Исследования, которые показаны в первую очередь
- erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
- CBC
Исследования, проведение которых нужно рассмотреть
- TSH
- ultrasound
- MRI
- serum protein electrophoresis
- serum creatine phosphokinase
- rheumatoid factor
- anti-cyclic citrullinated peptide antibodies
Неотложные исследования
- interleukin (IL)-6
- fluorodeoxyglucose F-18 PET scan
Алгоритм лечения
initial presentation
treatment-resistant or relapse or disease exacerbation
Составители
Авторы
Ari Weinreb, MD, PhD
Associate Chief of Rheumatology
VA Greater Los Angeles Healthcare System
Associate Clinical Professor of Medicine
David Geffen School of Medicine at UCLA
Los Angeles
CA
Раскрытие информации
AW declares that he has no competing interests.
Выражение благодарностей
Dr Ari Weinreb would like to gratefully acknowledge Dr Lynell Newmarch, a previous contributor to this topic.
Раскрытие информации
LN declares that she has no competing interests.
Рецензенты
Brian F. Mandell, MD, PhD, FACR
Vice Chairman of Medicine for Education
Professor of Medicine
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University
Editor in Chief
Cleveland Clinic Journal of Medicine
Cleveland Clinic
Cleveland
OH
Раскрытие информации
BFM declares that he has no competing interests.
Kuntal Chakravarty, FRCP (London), FRCP (Glasgow), FRCP (Ireland), FACP (USA), FACR (USA)
Consultant Rheumatologist
BHRT University Hospital
Queen’s Hospital
Romford
UK
Раскрытие информации
KC declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Nothnagl T, Leeb BF. Diagnosis, differential diagnosis and treatment of polymyalgia rheumatica. Drugs Aging. 2006;23:391-402. Аннотация
Buttgereit F, Dejaco C, Matteson EL, et al. Polymyalgia rheumatica and giant cell arteritis: A systematic review. JAMA. 2016 Jun 14;315(22):2442-58. Аннотация
Dejaco C, Singh YP, Perel P, et al; European League Against Rheumatism; American College of Rheumatology. 2015 recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheumatol. 2015;67:2569-2580.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Giant cell arteritis (GCA)
- Early rheumatoid arthritis (RA)
- Hypothyroidism
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