Differentiating Fibromyalgia from other diseases

Fibromyalgia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Fibromyalgia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
X Ray
CT
MRI
Ultrasound
Other Diagnostic Studies
Other Imaging Findings
Treatment
Medical Therapy
Psychotherapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Case Studies
Case #1
Differentiating Fibromyalgia from other diseases On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Differentiating Fibromyalgia from other diseases All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Differentiating Fibromyalgia from other diseases
CDC on Differentiating Fibromyalgia from other diseases
Differentiating Fibromyalgia from other diseases in the news
Blogs on Differentiating Fibromyalgia from other diseases
Directions to Hospitals Treating Fibromyalgia
Risk calculators and risk factors for Differentiating Fibromyalgia from other diseases

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

Differentiating Fibromyalgia from other Diseases

Fibromyalgia must be differentiated from other diseases that present with musculoskeletal pain

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