A man in his 40s with gastroesophageal reflux disease presented to his primary care physician with an 8-month history of “pain all over.” He reported an insidious onset of waxing and waning diffuse pain in and around the neck, elbows, shoulder blades, hips and knees, along with fatigue, unrefreshing sleep, and depressed mood. He denied morning stiffness, trauma, weight loss, joint swelling or redness, or personal or family history of rheumatological conditions. His only medications were ranitidine, and as needed naproxen and topical menthol with minimal relief of pain.

中文翻译：

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抗核抗体和亚血清学检测在评估纤维肌痛的可教学时间中的作用

一名40多岁患有胃食管反流疾病的男子向其初级保健医生介绍了8个月“全身疼痛”的病史。他报告说，在颈部，肘部，肩blade骨，臀部和膝盖及其周围会出现发蜡和逐渐消失的弥漫性疼痛，并伴有疲劳，无法恢复的睡眠和情绪低落。他否认早晨僵硬，外伤，体重减轻，关节肿胀或发红，或个人或家族的风湿病史。他唯一的药物是雷尼替丁，并根据需要服用萘普生和局部薄荷醇，以减轻疼痛。