Objective To investigate the causes of
misdiagnosis related to
rheumatism diseasecases.
Methods A search was performed in database WanFang to identify the misdiagnosed clinical cases
reports which were published in
Chinese Journal and a retrospective
analysis was conducted.All data were analyzed by
chi-square test and Fisher's exact test.Results We screened 705 citations and identified 215 articles on the
rheumatic diseases,finally,187
reports and 195 cases in total with definite
diagnosis were included,
accounting for 25.5% of the total number of misdiagnosed cases.Primary
vasculitis (72 cases),
rheumatoid arthritis (25 cases),
spondyloarthropathy (17 cases),
polymyositis (14 cases),
systemic lupus erythematosus (13 cases) and Sj(o)gren's
syndrome (SS) (12 cases) were amongst the top misdiagnosed
rheumatic diseases.There was no difference between 1998-2006 and 2007-2015 in the overall
misdiagnosis cases.Single
disease comparison,
polymyositis,
spondyloarthropathy and
IgG4 related disease were increased (P=0.002;P=0.034;P=0.060;respectively),while
polymyositis was delayed (P=0.002).
Rheumatism misdiagnosed cases reported mainly came from
tertiary hospitals and the department of
rheumatology.Conclusion Misdiagnosed
rheumatism are common in clinic.Strengthen the
physicians' continuous
education,the validity of clinical
thinking mode and rational use of diagnostic criteria are important to make correct
diagnosis.