大转子疼痛综合征合并纤维肌痛一例及文献复习

Greater trochanteric pain syndrome complicated with fibromyalgia:a case report and literature review

目的:了解器质性骨关节病常并发心理因素相关的纤维肌痛(FM),从而提高对“生物-心理-社会”整体医学模式的认识。方法:回顾性分析1例经临床诊断为大转子疼痛综合征(GTPS)并发FM患者的临床资料及诊疗过程,并复习相关文献。结果:患者起初诊断GTPS、髋关节骨关节炎,接受依托考昔等非甾体抗炎药治疗后病情改善不明显,后补充诊断FM,并加用盐酸度洛西汀等抗抑郁药物治疗后病情明显缓解。结论:器质性骨关节病可以并发心理因素相关的FM,导致疼痛等症状范围扩展,从而给诊断带来困难,应当予以重视。

Objective:To understand that organic osteoarthropathy were usually accompanied by fibromyalgia(FM),which was often associated with psychological factors,so as to improve the understanding of the overall medical model of“bio-psycho-social”.Methods:Clinical data and process of diagnosis and treatment in a patient who was clinically confirmed of greater trochanteric pain syndrome(GTPS)with FM was analyzed and the relevant literature was reviewed.Results:The patient was initially diagnosed with GTPS and hip osteoarthritis,but the condition was not significantly improved after receiving non-steroidal anti-inflammatory drugs such as etoricoxib.However,all of the symptoms were complete remission followed by a supplementary diagnosis of FM after treatment with anti-anxiety drugs such as duloxetine hydrochloride.Conclusion:Organic osteoarthropathy can be complicated with FM related to psychological factors,leading to the expansion of range of symptoms such as pain and difficulties in diagnosing,which should be paid serious attention.