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==Overview==
==Overview==
==Differentiating Fibromyalgia from other Diseases==
==Differentiating Fibromyalgia from other Diseases==
Fibromyalgia must be differentiated from other diseases that present with musculoskeletal pain such as rheumatoid arthritis, SLE, chronic fatigue syndrome, spondyloarthritis, 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>
Fibromyalgia must be differentiated from other diseases that present with musculoskeletal pain such as rheumatoid arthritis, SLE, chronic fatigue syndrome, spondyloarthritis, 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>


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Revision as of 13:48, 14 June 2017

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

Overview

Differentiating Fibromyalgia from other Diseases

Fibromyalgia must be differentiated from other diseases that present with musculoskeletal pain such as rheumatoid arthritis, SLE, chronic fatigue syndrome, spondyloarthritis, polymyalgia rheumatica.[1][2][3][4][5]

Disease Differentiating signs and symptoms Differentiating 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
  • Maculopapular rash
  • Multi-system involvement
  • Positive anti-Smith antibodies
Chronic fatigue syndrome
  • Fatigue plus 4 of the following symptoms
  • (1) Short-term memory loss
  • (2) Sore throat
  • (3) tender lymph nodes in the neck or armpit
  • (4) muscle pain
  • (5) joint pain without swelling or redness
  • (6) headaches
  • (7) unrefreshing sleep
  • (8) malaise
  • Diagnosis of exclusions
  • Symptoms must present for more than 6 months
Spondyloarthritis
  • Axial skeletal pain and stiffness
  • Restricted spinal motion
  • Elevated ESR or CRP
  • Negative 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 corticosteroids
Osteoarthritis 
  • Localized joint pain
  • Restricted to affect joints
  • Older at onset
  • Xray of the involved joints demonstrate degenerative changes
Hypothyroidism
  • Systemic symptoms such as weight gain, constipation, dry skin
  • Muscular aching and prominent fatigue that improves on replacement of thyroid hormone.
  • TSH is elevated and free T4 is low.
Myopathaies(polymyositis and dermatomyositis)
  • Pelvic and shoulder girdle muscle weakness
  • Rash
  • Muscle biopsy confirms the diagnosis
  • Elevated CPK enzyme
Neuropathy
  • Numbness and tingling
  • Paresthesia
  • Abnormal EMG

References

  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. ↑ Clauw DJ (2014). "Fibromyalgia: a clinical review". JAMA. 311 (15): 1547–55. doi:10.1001/jama.2014.3266. PMID 24737367.
  3. ↑ 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. ↑ 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. ↑ 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.

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