成人疑似炎症性关节炎常见检查的实用性。

IF 3.4 Q2 PHARMACOLOGY & PHARMACY
Nicola Cook, Rachelle Buchbinder
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引用次数: 0

摘要

炎症性关节炎可能是炎症性风湿病的主要特征或组成部分之一。这是一种临床诊断,主要根据患者的病史和检查结果做出。特定的检查,如类风湿因子和人类白细胞抗原 B27 基因,可在临床表现有提示的情况下支持诊断,但不能仅凭这些检查就做出诊断,因为在健康人身上也可能出现阳性结果。为了降低假阳性结果的可能性,实验室和放射学检查应根据检测前的可能性来确定疑似诊断。肌肉骨骼症状是全科诊疗中的常见表现,而增加对炎症性关节炎怀疑的具体特征包括长期晨僵(1 小时以上),且运动或活动后症状有所改善。广泛的 "风湿病学检查 "会增加出现假阳性结果的可能性,因此应尽量避免,以防止不必要的进一步检查和治疗,并避免患者和医生产生不必要的焦虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Utility of common investigations for suspected inflammatory arthritis in adults.

Inflammatory arthritis may be the principal feature or one component of an inflammatory rheumatological disease. It is a clinical diagnosis, principally made based on the patient's history and examination. Specific investigations, such as rheumatoid factor and human leucocyte antigen B27 gene, may support the diagnosis in the context of a suggestive clinical presentation, but a diagnosis cannot be made based on these tests alone because positive results may also be seen in healthy individuals. To reduce the likelihood of false positive results, laboratory and radiological investigations should be tailored to the suspected diagnosis based on pretest probability. While musculoskeletal symptoms are a common presentation in general practice, specific features that increase suspicion of an inflammatory arthritis include prolonged morning stiffness (more than 1 hour) that is improved by exercise or movement. A broad 'rheumatological panel' increases the likelihood of false positive results and should be avoided to prevent unnecessary further investigations and treatment, and unwarranted anxiety in both the patient and the doctor.

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来源期刊
Australian Prescriber
Australian Prescriber MEDICINE, GENERAL & INTERNAL-PHARMACOLOGY & PHARMACY
CiteScore
3.80
自引率
7.40%
发文量
71
审稿时长
>12 weeks
期刊介绍: Australian Prescriber is Australia''s free, national, independent journal of drugs and therapeutics. It is published every two months online. Our purpose is to help health professionals make informed choices when prescribing, including whether to prescribe a drug or not. To do this we provide independent, reliable and accessible information. As well as publishing short didactic reviews, we facilitate debate about complex, controversial or uncertain therapeutic areas. We are part of NPS MedicineWise, an independent, non-profit organisation providing medicines information and resources for health professionals, and stakeholders involved in the quality use of medicines. NPS MedicineWise is funded by the Australian Government Department of Health.
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