小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 肩胛带/骨盆带僵硬
- 肩胛带/骨盆带疼痛
- 对皮质类固醇的快速反应
其他诊断因素
- 急性发作
- 低热
- 厌食
- 体重减轻
- 不适感
- 抑郁症
- 乏力
- 少关节型关节炎
危险因素
- 年龄≥50 岁
- 巨细胞动脉炎 (GCA)
- 女性
诊断性检查
首要检查
- 红细胞沉降率 (ESR)
- C 反应蛋白 (CRP)
- 全血细胞计数 (FBC)
需考虑的检查
- TSH
- 超声
- 磁共振成像 (MRI)
- 血清蛋白电泳
- 类风湿因子
- 抗环瓜氨酸肽抗体
新兴检查
- 白细胞介素 (IL)-6
- 氟脱氧葡萄糖 F-18 PET 扫描
治疗流程
初始表现
难治性疾病、复发或疾病加重
撰稿人
作者
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
利益声明
AW declares that he has no competing interests.
鸣谢
Dr Ari Weinreb would like to gratefully acknowledge Dr Lynell Newmarch, a previous contributor to this topic.
利益声明
LN declares that she has no competing interests.
同行评议者
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
利益声明
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
利益声明
KC declares that he has no competing interests.
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