Diagnosis and differential diagnosis of fibromyalgia. Premedline via ovid, in addition to a manual search in the brazilian digital library of. The differential diagnosis of the diseases that can produce the spread of muscular pain include more than twenty conditions. In an internet survey by the national fibromyalgia association, 1735 patients age 3178 years reported. If your doctor cant find another reason for your symptoms, shell use a twopart process to help figure out if you have fibromyalgia. While fibromyalgia and multiple sclerosis ms do share the symptom of pain, fibromyalgia is a musculoskeletal condition and multiple sclerosis is a neurological condition. Fibromyalgia beyond the basics approach to the adult patient with fatigue.
Diagnosis and treatment of chronic mycoplasmal infections. What is the prognosis for a person diagnosed with fibromyalgia. Diagnosis and treatment of chronic mycoplasmal infections in. Fibromyalgia is a common neurologic health problem that causes widespread pain and tenderness sensitivity to touch. Medications can help reduce the pain of fibromyalgia and improve sleep. Feb 02, 2020 an avalanche of useless fibromyalgia research. Clauw describes the syndrome as a diffuse problem of sensory volume control such that patients have a lower threshold of pain and of other stimuli, such as heat, noise, and strong odors. Since there are no lab or imaging tests available for fibromyalgia, it can be a difficult condition to diagnose. Fibromyalgia is a difficult condition to diagnose because there is no blood or imaging test for it. Diagnosis and differential diagnosis of fibromyalgia the. A doctor needs to rely a great deal on patient history. Fibromyalgia syndrome fms presents with widespread soft tissue pain.
Can the 2010 criteria be considered in the diagnosis of fm. Fibromyalgia can often be difficult to diagnose because there are a variety of illnesses that can have similar symptoms to the condition. The emphasis is on minimizing symptoms and improving general health. The multiple symptoms of fibromyalgia often overlap with those of related disorders and may further complicate the diagnosis. To help doctors make an accurate diagnosis of fibromyalgia, the american college of rheumatology. A chronic disease of unknown etiology, it is characterized by widespread pain and symptoms that. Fibromyalgia is currently understood to be a disorder of central pain processing or a syndrome of central sensitivity. Treatment of fibromyalgia syndrome with traditional chinese. Since 1990, diagnosis has been principally based on.
The pain and tenderness tend to come and go, and move about the body. In general, treatments for fibromyalgia include both medication and selfcare. Apr 29, 2010 when applied to study patients, using the acr classification criteria definition of fibromyalgia, the mean sd ss scale score for fibromyalgia was 8. Pdf ever since it was first defined, fibromyalgia fm has been considered one of the most. Apr 19, 2016 while fibromyalgia and multiple sclerosis ms do share the symptom of pain, fibromyalgia is a musculoskeletal condition and multiple sclerosis is a neurological condition. Pdf differential diagnosis of fibromyalgia syndrome. Fibromyalgia patients showed lower plasma fractalkine than healthy women. Using the 1990 acr classification criteria, the prevalence of fibromyalgia in the general population of the united states is. There is no specific lab test for the condition and symptoms may overlap those of other disorders, such as rheumatoid arthritis or lupus. Diagnosis, etiology, and therapy of fibromyalgia springerlink.
A patient meets the diagnostic criteria for fibromyalgia if the following 3 conditions are met. The american college of rheumatology preliminary diagnostic. Oct 07, 2011 fibromyalgia fm is a diagnosis of exclusion used to describe patients with a cluster of symptoms that are not attributed to a recognized disease process. The diagnosis of fibromyalgia, similar to other functional disorders, requires that organic diseases are not causing the symptoms. People with fibromyalgia have tender points on the body. Symptoms have been present at a similar level for at least 3 months. It represents a heterogeneous group of conditions resulting in common histopathologic and radiologic changes. Jul 15, 2007 fibromyalgia is an idiopathic, chronic, nonarticular pain syndrome with generalized tender points. Study of fms has provided better understanding of a variety of symptoms experienced by distressed patients, and legitimizes its existence. Evidence collection was performed based on 9 questions regarding the diagnosis of fibromyalgia, structured using the patient, intervention or indicator, comparison and outcome p. Spanish version of the fibromyalgia rapid screening tool. Osteoarthritis differential diagnoses medscape reference. The diagnosis can be made with a careful examination. Anyone can get it, but it is most common in middle.
Fibromyalgia fm is a diagnosis of exclusion used to describe patients with a cluster of symptoms that are not attributed to a recognized disease process. Fibromyalgia and sensitivtitleabstract or sensitivity and speci. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. One of the most challenging diagnostic dilemmas that clinicians face is distinguishing fibromyalgia from other central pain disorders e. Nicolson the institute for molecular medicine, 15162 triton lane huntington beach, ca 92649 summary. New guidelines for the diagnosis of fibromyalgia scielo.
Many doctors still use a tender points test to help diagnose the condition. New guidelines for the diagnosis of fibromyalgia sciencedirect. The differential diagnosis of fibromyalgia fm is large, given the number of conditions that can present with signs or symptoms of fm, such as pain, fatigue and sleep disturbance, and symptoms of cognitive dysfunction and psychiatric disease. The patient population should include those with relevant differential. Some researchers think there is a link between fibromyalgia and certain forms of depression and chronic anxiety. A current perspective of differential diagnosis, abstract patients eventually diagnosed as having the fibromyalgia syndrome often have symptoms which suggest alternate diagnosis such as peripheral neuropathy, spondylitis, metabolic myopathy, polymyalgia, early rheumatoid arthritis. Differential diagnosis of pain and fibromyalgia core.
Feelings of sadness or being down are common, and some people with fibromyalgia have depression. To help doctors make an accurate diagnosis of fibromyalgia, the american college of rheumatology recommends doctors consider three criteria. Fibromyalgia is a common rheumatologic disorder that is underdiagnosed. The hallmark symptom of fm is chronic widespread pain which is bilateral, above and below the waist, and involving the axial skeleton andor torso. Pdf on jul 1, 2006, schneider m and others published differential diagnosis of fibromyalgia syndrome find, read and cite all the research you need on researchgate. Soluble fractalkine in the plasma of fibromyalgia patients. Determining the true cause of your symptoms is key to receiving proper treatment. Other problems to consider in the differential diagnosis of fibromyalgia include the following.
Diagnosis and treatment of chronic mycoplasmal infections in fibromyalgia and chronic fatigue syndromes. Recognition that these mechanisms are important in all distressed patients results in proper diagnosis and treatment. Fibromyalgia is a disorder that causes muscle pain and fatigue. Fibromyalgia symptoms are worse and the quality of life is poorer for young younger than 39 years or middleage 4059 years patients with fibromyalgia versus older older than 60 years patients jiao 2014. The hallmark symptom of fm is chronic widespread pain which is bilateral, above and below. The symptoms, and the mechanisms responsible for them, are very real. Osteoarthritis is the most common type of joint disease, affecting more than 20 million individuals in the united states alone see epidemiology. But all of these symptoms are common to many other conditions.
Testing is often done to rule out other conditions that could cause pain, including arthritis, infections and lyme disease. Fibromyalgia is a chronic health condition that involves widespread pain throughout your body, tenderness in certain areas, and fatigue. Etiology, pathogenesis, diagnosis, and treatment article pdf available in pain research and treatment 20126. Fred wolfe is as expert as a fibromyalgia expert can get. Nicolson the institute for molecular medicine, 15162 triton lane huntington beach, ca. Hints early dx fm characteristic features and diagnostic evaluation for fm differential diagnosis of fibromyalgia fibromyalgia v myofascial pain sxs distinguish cfs fm and tmd clinical similarities between fibromyalgia and cfs related topics. The symptoms may have been going on for years, but because the criteria for diagnosing fms failed to take into. Apr 23, 2020 fibromyalgia is currently understood to be a disorder of central pain processing or a syndrome of central sensitivity. Fibromyalgia fm syndrome is a complex and challenging condition for healthcare systems worldwide. Differential diagnosis between fibromyalgia syndrome and. Perhaps one of the most frustrating things for a person with fibromyalgia syndrome fms to have had to endure is the unreasonably long period of time it took to get a definitive diagnosis. Treatment of fibromyalgia syndrome 99 approximately 4 kgcm2 of pressure through their thumbs on corresponding acupuncture points to iden tify positive tender points. Fibromyalgia is a chronic functional illness that presents with widespread musculoskeletal pain as well as a constellation of symptoms including fatigue, cognitive dysfunction, sleep difficulties, stiffness, anxiety, and depressed mood.
The ss scale enables assessment of fibromyalgia symptom severity in persons. Most often, people with this chronic longterm illness are fatigued very tired and have sleep problems. Nicolson, marwan nasralla, joerg haier and nancy l. Fibromyalgia differential diagnoses medscape reference. Refer to the table 2 for a comparison of the tender points identified by the american college of rheuma tology and the acupuncture points per traditional chinese medicine theories. It is a multisystem disease characterized by sleep disturbance, fatigue, headache, morning. Clauw describes the syndrome as a diffuse problem of sensory volume control such that patients have a lower threshold of pain. New evidence demonstrates that fibromyalgia may have undiagnosed biological causes or may be due to the action of chemicals either in the work place or in the environmen. Fibromyalgia symptoms include widespread body pain, fatigue, poor sleep and mood problems.
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