Differentiating Fibromyalgia from other diseases: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Fibromyalgia]] | |||
{{CMG}}; {{AE}} {{ADG}} | {{CMG}}; {{AE}} {{ADG}} | ||
==Overview== | ==Overview== | ||
Fibromyalgia must be differentiated from other diseases that present with [[pain]], [[fatigue]] and [[Insomnia|sleep disturbance]], and symptoms of | Fibromyalgia must be differentiated from other diseases that present with [[pain]], [[fatigue]] and [[Insomnia|sleep disturbance]], and symptoms of cognitive dysfunction and [[psychiatric disease]] such as [[rheumatoid arthritis]], [[SLE]], [[chronic fatigue syndrome]], [[spondyloarthritis]], and [[polymyalgia rheumatica]].<ref name="pmid15547167">{{cite journal |vauthors=Goldenberg DL, Burckhardt C, Crofford L |title=Management of fibromyalgia syndrome |journal=JAMA |volume=292 |issue=19 |pages=2388–95 |year=2004 |pmid=15547167 |doi=10.1001/jama.292.19.2388 |url=}}</ref><ref name="pmid24737367">{{cite journal |vauthors=Clauw DJ |title=Fibromyalgia: a clinical review |journal=JAMA |volume=311 |issue=15 |pages=1547–55 |year=2014 |pmid=24737367 |doi=10.1001/jama.2014.3266 |url=}}</ref><ref name="pmid26445775">{{cite journal |vauthors=Borchers AT, Gershwin ME |title=Fibromyalgia: A Critical and Comprehensive Review |journal=Clin Rev Allergy Immunol |volume=49 |issue=2 |pages=100–51 |year=2015 |pmid=26445775 |doi=10.1007/s12016-015-8509-4 |url=}}</ref><ref name="pmid23775553">{{cite journal |vauthors=Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, Henningsen P |title=[Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines] |language=German |journal=Z Psychosom Med Psychother |volume=59 |issue=2 |pages=132–52 |year=2013 |pmid=23775553 |doi=10.13109/zptm.2013.59.2.132 |url=}}</ref><ref name="pmid19050952">{{cite journal |vauthors=Eich W, Häuser W, Friedel E, Klement A, Herrmann M, Petzke F, Offenbächer M, Schiltenwolf M, Sommer C, Tölle T, Henningsen P |title=[Definition, classification and diagnosis of fibromyalgia syndrome] |language=German |journal=Z Rheumatol |volume=67 |issue=8 |pages=665–6, 668–72, 674–6 |year=2008 |pmid=19050952 |doi=10.1007/s00393-008-0404-4 |url=}}</ref> | ||
==Differentiating Fibromyalgia from other Diseases== | ==Differentiating Fibromyalgia from other Diseases== | ||
[[Fibromyalgia]] must be differentiated from other diseases that present with [[pain]], [[fatigue]] and [[Insomnia|sleep disturbance]], and symptoms of | [[Fibromyalgia]] must be differentiated from other diseases that present with [[pain]], [[fatigue]] and [[Insomnia|sleep disturbance]], and symptoms of cognitive dysfunction and [[psychiatric disease]] such as [[rheumatoid arthritis]], [[SLE]], [[chronic fatigue syndrome]], [[spondyloarthritis]], and [[polymyalgia rheumatica]].<ref name="pmid15547167">{{cite journal |vauthors=Goldenberg DL, Burckhardt C, Crofford L |title=Management of fibromyalgia syndrome |journal=JAMA |volume=292 |issue=19 |pages=2388–95 |year=2004 |pmid=15547167 |doi=10.1001/jama.292.19.2388 |url=}}</ref><ref name="pmid24737367">{{cite journal |vauthors=Clauw DJ |title=Fibromyalgia: a clinical review |journal=JAMA |volume=311 |issue=15 |pages=1547–55 |year=2014 |pmid=24737367 |doi=10.1001/jama.2014.3266 |url=}}</ref><ref name="pmid26445775">{{cite journal |vauthors=Borchers AT, Gershwin ME |title=Fibromyalgia: A Critical and Comprehensive Review |journal=Clin Rev Allergy Immunol |volume=49 |issue=2 |pages=100–51 |year=2015 |pmid=26445775 |doi=10.1007/s12016-015-8509-4 |url=}}</ref><ref name="pmid23775553">{{cite journal |vauthors=Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, Henningsen P |title=[Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines] |language=German |journal=Z Psychosom Med Psychother |volume=59 |issue=2 |pages=132–52 |year=2013 |pmid=23775553 |doi=10.13109/zptm.2013.59.2.132 |url=}}</ref><ref name="pmid19050952">{{cite journal |vauthors=Eich W, Häuser W, Friedel E, Klement A, Herrmann M, Petzke F, Offenbächer M, Schiltenwolf M, Sommer C, Tölle T, Henningsen P |title=[Definition, classification and diagnosis of fibromyalgia syndrome] |language=German |journal=Z Rheumatol |volume=67 |issue=8 |pages=665–6, 668–72, 674–6 |year=2008 |pmid=19050952 |doi=10.1007/s00393-008-0404-4 |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
!Disease | !Disease | ||
!Differentiating signs and symptoms | !Differentiating signs and symptoms | ||
! | !Diagnostic findings | ||
|- | |||
|[[Fibromyalgia]] | |||
| | |||
* Symptoms have been present at a similar level for at least 3 months. | |||
* Chronic [[musculoskeletal pain]] with multiple tender points | |||
* [[Stiffness]], [[numbness]], and [[fatigue]] | |||
* [[Headaches]] | |||
* [[Sleep disorder]] | |||
| | |||
*All lab tests are normal | |||
|- | |- | ||
|[[Rheumatoid arthritis]] | |[[Rheumatoid arthritis]] | ||
| | | | ||
* Multiple joint swelling | * Multiple [[joint swelling]] | ||
* Morning stiffness | * Morning [[stiffness]] | ||
* [[Rheumatoid nodules]] | * [[Rheumatoid nodules]] | ||
| | | | ||
* [[Rheumatoid factor|RF]] or anti-cyclic citrullinated protein (CCP) antibody is positive. | * [[Rheumatoid factor|RF]] or [[Anti-citrullinated protein antibody|anti-cyclic citrullinated protein (CCP) antibody]] is positive. | ||
* Markers of systemic inflammation ([[ESR]], [[CRP]]) are typically elevated. | * Markers of systemic inflammation ([[ESR]], [[CRP]]) are typically elevated. | ||
| Line 29: | Line 39: | ||
* Multi-system involvement | * Multi-system involvement | ||
| | | | ||
*Positive anti-Smith antibodies | *Positive anti-Smith [[antibodies]] | ||
|- | |- | ||
|[[Chronic fatigue syndrome]] | |[[Chronic fatigue syndrome]] | ||
| | |Fatigue plus 4 of the following symptoms: | ||
*Short-term [[memory loss]] | |||
* | *[[Sore throat]] | ||
* | *Tender [[lymph nodes]] in the neck or armpit | ||
* | *[[Muscle pain]] | ||
* | *[[Joint pain]] without [[swelling]] or [[Redness of the skin|redness]] | ||
* | *[[Headaches]] | ||
* | *[[Insomnia]] | ||
* | *[[Malaise]] | ||
* | |||
| | | | ||
*Diagnosis of exclusions | *Diagnosis of exclusions | ||
| Line 48: | Line 57: | ||
|[[Spondyloarthritis]] | |[[Spondyloarthritis]] | ||
| | | | ||
* Axial skeletal pain and stiffness | * [[Axial skeleton|Axial skeletal]] pain and [[stiffness]] | ||
* Restricted spinal motion | * Restricted spinal motion | ||
| | | | ||
| Line 54: | Line 63: | ||
* Negative [[RF]] | * Negative [[RF]] | ||
* Bamboo spine on | * [[Bamboo spine]] on [[x-ray]] | ||
|- | |- | ||
|[[Polymyalgia rheumatica]] | |[[Polymyalgia rheumatica]] | ||
| | | | ||
* Older at | * Older at onset | ||
* Generalized stiffness | * Generalized [[stiffness]] | ||
| | | | ||
* An elevated [[erythrocyte sedimentation rate]] ([[ESR]]) OR [[C-reactive protein]] (CRP | * An elevated [[erythrocyte sedimentation rate]] ([[ESR]]) OR [[C-reactive protein]] (CRP) | ||
* Response to [[corticosteroids]] | * Response to [[corticosteroids]] | ||
|- | |- | ||
|[[Osteoarthritis]] | |[[Osteoarthritis]] | ||
| | | | ||
* Localized joint pain | * Localized [[joint pain]] | ||
* Restricted to affect joints | * Restricted to affect joints | ||
* Older at onset | * Older at onset | ||
| | | | ||
* | * [[X-ray]] of the involved joints demonstrate degenerative changes | ||
|- | |- | ||
|[[Hypothyroidism]] | |[[Hypothyroidism]] | ||
| | | | ||
*Systemic symptoms such as [[weight gain]], [[constipation]], [[dry skin]] | *Systemic symptoms such as [[weight gain]], [[constipation]], [[dry skin]] | ||
*Muscular aching and prominent [[fatigue]] that improves on replacement of [[thyroid hormone]]. | *[[Myalgia|Muscular aching]] and prominent [[fatigue]] that improves on replacement of [[thyroid hormone]]. | ||
| | | | ||
*[[TSH]] is elevated and free [[T4]] is low. | *[[TSH]] is elevated and free [[T4]] is low. | ||
|- | |- | ||
|Myopathaies([[polymyositis]] and [[dermatomyositis]]) | |Myopathaies ([[polymyositis]] and [[dermatomyositis]]) | ||
| | | | ||
*Pelvic and shoulder girdle [[muscle weakness]] | *Pelvic and shoulder girdle [[muscle weakness]] | ||
*[[Rash]] | *[[Rash]] | ||
| | | | ||
*Muscle biopsy confirms the diagnosis | *[[Muscle biopsy]] confirms the diagnosis | ||
*Elevated [[CPK enzyme]] | *Elevated [[CPK|CPK enzyme]] | ||
|- | |- | ||
|[[Neuropathy]] | |[[Neuropathy]] | ||
| Line 97: | Line 106: | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 20:33, 20 February 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Fibromyalgia must be differentiated from other diseases that present with pain, fatigue and sleep disturbance, and symptoms of cognitive dysfunction and psychiatric disease such as rheumatoid arthritis, SLE, chronic fatigue syndrome, spondyloarthritis, and polymyalgia rheumatica.[1][2][3][4][5]
Differentiating Fibromyalgia from other Diseases
Fibromyalgia must be differentiated from other diseases that present with pain, fatigue and sleep disturbance, and symptoms of cognitive dysfunction and psychiatric disease such as rheumatoid arthritis, SLE, chronic fatigue syndrome, spondyloarthritis, and polymyalgia rheumatica.[1][2][3][4][5]
| Disease | Differentiating signs and symptoms | Diagnostic findings |
|---|---|---|
| Fibromyalgia |
|
|
| Rheumatoid arthritis |
|
|
| SLE |
|
|
| Chronic fatigue syndrome | Fatigue plus 4 of the following symptoms:
|
|
| Spondyloarthritis |
|
|
| Polymyalgia rheumatica |
|
|
| Osteoarthritis |
|
|
| Hypothyroidism |
|
|
| Myopathaies (polymyositis and dermatomyositis) |
|
|
| Neuropathy |
|
References
- ↑ 1.0 1.1 Goldenberg DL, Burckhardt C, Crofford L (2004). "Management of fibromyalgia syndrome". JAMA. 292 (19): 2388–95. doi:10.1001/jama.292.19.2388. PMID 15547167.
- ↑ 2.0 2.1 Clauw DJ (2014). "Fibromyalgia: a clinical review". JAMA. 311 (15): 1547–55. doi:10.1001/jama.2014.3266. PMID 24737367.
- ↑ 3.0 3.1 Borchers AT, Gershwin ME (2015). "Fibromyalgia: A Critical and Comprehensive Review". Clin Rev Allergy Immunol. 49 (2): 100–51. doi:10.1007/s12016-015-8509-4. PMID 26445775.
- ↑ 4.0 4.1 Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, Henningsen P (2013). "[Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines]". Z Psychosom Med Psychother (in German). 59 (2): 132–52. doi:10.13109/zptm.2013.59.2.132. PMID 23775553.
- ↑ 5.0 5.1 Eich W, Häuser W, Friedel E, Klement A, Herrmann M, Petzke F, Offenbächer M, Schiltenwolf M, Sommer C, Tölle T, Henningsen P (2008). "[Definition, classification and diagnosis of fibromyalgia syndrome]". Z Rheumatol (in German). 67 (8): 665–6, 668–72, 674–6. doi:10.1007/s00393-008-0404-4. PMID 19050952.