Differentiating Fibromyalgia from other diseases

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Fibromyalgia from other Diseases

A number of other disorders can produce similar symptoms to fibromyalgia:

• Chronic fatigue syndrome
• Depression
• Ehlers-Danlos syndrome
• Gulf War syndrome
• Influenza
• Lead poisoning
• Lupus erythematosus
• Lyme disease
• Mercury poisoning
• Myofascial pain syndrome
• Sympathetic pain sydromes (RSD, CRPS)
• Tendinitis
• Thyroid disease
• Vitamin B12 deficiency
• Vitamin D deficiency
• Whiplash-associated disorder
• Multiple chemical sensitivity

Disease	Differentiating signs and symptoms	Diifferentiating labs
Rheumatoid arthritis	Multiple joint swelling Morning stiffness Rheumatoid nodules	RF or anti-cyclic citrullinated protein (CCP) antibody is positive. Markers of systemic inflammation (ESR, CRP) are typically elevated.
SLE	Maculo-papular rash Multi system involvement
Chronic fatigue syndrome
Spondyloarthritis	Axial skeletal pain and stiffness Restricted spinal motion	Elevated ESR or CRP Negtive RF Bamboo spine on X-ray
Polymyalgia rheumatica	older at onset  generalized stiffness	An elevated erythrocyte sedimentation rate (ESR) OR C-reactive protein (CRP Response to corticoste