■炎症通常模仿肌肉骨骼表现,导致初级和二级保健的诊断延迟。物理治疗师可以在早期识别中发挥关键作用,分诊,以及对炎性病症如风湿性多肌痛(PMR)的后续转诊。虽然PMR相对罕见,识别其特征表现,血清炎症标志物升高,是在专业风湿病咨询后启动适当干预的急需步骤。
本病例详细介绍了一名62岁男性因认为是脊柱原因的双侧臀部持续疼痛而转诊至二级脊柱护理中心的评估和诊断。骨科分诊理疗师进行了彻底的初步评估,发现以下显着的炎症特征后,对PMR的怀疑:双侧臀部突然发作,肩部疼痛和僵硬,早晨僵硬持续一小时,长时间不活动会加剧疼痛,和对非甾体抗炎药的积极反应。
■进一步的调查显示炎症标志物升高,需要及时进行风湿病学咨询,并随后确认PMR的诊断。高剂量口服皮质类固醇治疗的早期开始导致疼痛和相关症状的立即缓解。
■这个案例突出了识别持续性肌肉骨骼疾病的显著炎症特征的重要性,特别是在国际上物理治疗作用范围不断演变的背景下。虽然许多炎症的明确诊断需要进一步的调查和风湿病咨询,包括PMR,提高临床医师对显著炎症特征的认识有助于此类病例的早期识别和后续分诊.
UNASSIGNED: Inflammatory conditions often mimic musculoskeletal presentations, causing diagnostic delays in primary and secondary care. Physiotherapists can play a pivotal role in the early recognition, triage, and onward referral for inflammatory conditions such as polymyalgia rheumatica (PMR). While PMR is relatively rare, recognition of its characteristic presentation, alongside elevated serum inflammatory markers, is a much-needed step to initiate appropriate intervention following specialized rheumatological consultation.
UNASSIGNED: This
case details the assessment and diagnosis of a 62-year-old male referred to a secondary care spine center for persisting bilateral buttock pain presumed to be of spinal origin. A thorough initial evaluation by an orthopedic-triage physiotherapist raised the suspicion of PMR upon identification of the following salient inflammatory features: sudden onset of bilateral buttock and shoulder pain and stiffness, morning stiffness lasting one hour, pain aggravated by prolonged inactivity, and a positive response to non-steroidal anti-inflammatory medication.
UNASSIGNED: Further investigations revealed elevated inflammatory markers warranting prompt rheumatology consultation and subsequently confirming the diagnosis of PMR. Early initiation of high dose oral corticosteroid therapy resulted in immediate relief of pain and associated symptoms.
UNASSIGNED: This
case highlights the significance of recognizing salient inflammatory features in persistent musculoskeletal complaints, particularly in the context of the evolving scope of physiotherapy roles internationally. While further investigations and rheumatological consultation are required for the definitive diagnosis of many inflammatory conditions, including PMR, greater clinician awareness of salient inflammatory features can aid the earlier identification and subsequent triage of such cases.