译者：刘樱 校对：刘素苗 审核：张莉芸

Abstract

Polymyalgia rheumatica (PMR) is a common inflammatory condition that often affects people over the age of 50 years. Characteristic symptoms are shoulder and hip girdle pain and prolonged morning stiffness. Markers of inflammation are often elevated. Clinicians are often faced with the challenge of distinguishing PMR from other conditions, particularly rheumatoid arthritis and spondyloarthropathy that can mimic symptoms of PMR in older people. Additionally, there is an association between PMR and giant cell arteritis, a common large-vessel vasculitis which also affects people over the age of 50 years. Imaging of the large vessels in asymptomatic patients with PMR often reveals findings of subclinical vasculitis. Presently, there are no tests that are specific for the diagnosis of PMR and clinicians rely on a combination of history, physical examination, laboratory tests and imaging studies to make a diagnosis.A recent undertaking by the European League Against Rheumatism/American College of Rheumatology has led to the publication of provisional classification criteria of PMR. Ultrasonography, which is being increasingly used by rheumatologists, can greatly aid in the diagnosis of PMR and often shows changes of synovitis and tenosynovitis. Treatment consists of low doses of glucocorticoids which are associated with morbidity.Evaluation of newer biologic therapies targeting inflammatory cytokines is underway. Despite treatment, relapses are common.

摘要

风湿性多肌痛是一种常见的炎症反应，好发于50岁以上的老年人。特征性症状是肩胛带和腰带肌疼痛、晨僵。炎性指征常常会升高。临床医师面对风湿性多肌痛时需要和其他的疾病鉴别，特别是老年患者中出现类似症状的类风湿关节炎和血清阴性脊柱关节病。另外，风湿性多肌痛和巨细胞动脉炎有一定的相关性，巨细胞动脉炎亦好发于50岁以上人群。PMR的无症状的临床患者大血管成像往往显示出亚临床血管炎表现。目前，还没有一项特异性的检查诊断风湿性多肌痛，临床医生需结合病史，体格检查，实验室检查和影像学检查做出诊断。最近，欧洲抗风湿联盟/美国风湿病学院提出了风湿性多肌痛的临时分类标准。超声检查，越来越多地用于风湿病，可以大大的帮助诊断PMR以及显示滑膜炎和腱鞘炎的变化。常用的治疗包括低剂量的糖皮质激素，与发病率相关。新的靶向治疗炎性细胞因子的生物治疗正在探测中。尽管治疗，复发是常见的。

引自：Advances and challenges in the diagnosis and treatment of polymyalgia rheumatica.