译者：梁娜娜校对：杨艳丽审核：张莉芸

Abstract：Polymyalgiarheumatica (PMR)isacommoninflammatoryconditionthatoftenaffectspeopleovertheageof50years.Characteristicsymptomsareshoulderandhipgirdlepainandprolongedmorningstiffness.Markersofinflammationareoftenelevated.CliniciansareoftenfacedwiththechallengeofdistinguishingPMRfromotherconditions,particularlyrheumatoidarthritisandspondyloarthropathythatcanmimicsymptomsofPMRinolderpeople.Additionally,thereisanassociationbetweenPMRandgiantcellarteritis,acommonlarge-vesselvasculitiswhichalsoaffectspeopleovertheageof50years.ImagingofthelargevesselsinasymptomaticpatientswithPMRoftenrevealsfindingsofsubclinicalvasculitis.Presently,therearenoteststhatarespecificforthediagnosisofPMRandcliniciansrelyona combinationofhistory,physicalexamination,laboratorytestsandimagingstudiestomakeadiagnosis.ArecentundertakingbytheEuropeanLeagueAgainstRheumatism/AmericanCollegeofRheumatologyhasledtothepublicationofprovisionalclassificationcriteriaofPMR.Ultrasonography,whichisbeingincreasinglyusedbyrheumatologists,cangreatlyaidinthediagnosisofPMRandoftenshowschangesofsynovitisandtenosynovitis.Treatmentconsistsoflowdosesofglucocorticoidswhichareassociatedwithmorbidity.Evaluationofnewerbiologictherapiestargetinginflammatorycytokinesisunderway.Despitetreatment,relapsesarecommon.

摘要：风湿性多肌痛（ PMR ）是好发于50岁以上老年人的一种常见的炎症病变。典型症状是肩胛带及臀区肌肉疼痛和长时间的晨僵。炎症标志物通常较高。临床医师往往要对PMR和具有类似临床表现的类风湿关节炎及脊柱关节病进行鉴别诊断，此外，巨细胞动脉炎也好发于老年人，也需要鉴别。临床上没有症状的PMR患者大血管成像示：亚临床血管炎，目前，PMR无特异的诊断标准，临床医师只能依据病史，体格检查，实验室检查和影像学检查进行诊断，我们通常采用的是欧洲抗风湿协会/美国风湿病学院公布的关于PMR的临时分类标准，超声检查被广泛应用于风湿病，不仅有助于诊断风湿性多肌痛，而且还可以显示出滑膜炎和腱鞘炎的改变，治疗上包括低剂量的糖皮质激素，这与疾病相关，旨在降低炎性因子的新的生物治疗方法评估正在进行。治疗好转后，容易复发。

引自：KermaniTA1,WarringtonKJ2. Advancesandchallengesinthediagnosisandtreatment ofpolymyalgiarheumatica. TherAdvMusculoskeletDis. 2014Feb; 6(1): 8-1.

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