Fibromyalgia diagnostic criteria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Diagnostic Criteria
There is still debate over what should be considered essential diagnostic criteria. The most widely accepted set of classification criteria for research purposes were elaborated in 1990 by the Multicenter Criteria Committee of the the American College of Rheumatology. These criteria, which are known informally as "the ACR 1990" define fibromyalgia according to the presence of the following criteria:
- A history of widespread pain lasting more than three months—affecting all four quadrants of the body, i.e., both sides, and above and below the waist.
- Tender points—there are 18 designated possible tender or trigger points (although a person with the disorder may feel pain in other areas as well). During diagnosis, four kilograms-force (39 newtons) of force is exerted at each of the 18 points; the patient must feel pain at 11 or more of these points for fibromyalgia to be considered.[1] Four kilograms of force is about the amount of pressure required to blanch the thumbnail when applying pressure. This set of criteria was developed by the American College of Rheumatology as a means of classifying an individual as having fibromyalgia for both clinical and research purposes. While these criteria for classification of patients were originally established as inclusion criteria for research purposes and were not intended for clinical diagnosis, they have become the de facto diagnostic criteria in the clinical setting. It should be noted that the number of tender points that may be active at any one time may vary with time and circumstance.
- It is important not to make fibromyalgia a diagnosis of inclusion (anyone with complex or chronic pain is given the diagnosis).mVery often if routine blood work including a rheumatic profile, X-Ray, MRI, Electrodiagnostics (EMG), Diagnostic musculoskeletal ultrasound or Thermography (for patients with weather sensitive pain) is obtained the root cause can be discovered.
References
- ↑ National Institute of Arthritis and Musculoskeletal and Skin Diseases (June 2004). "Questions and Answers About Fibromyalgia -- How Is Fibromyalgia Diagnosed?". National Institutes for Health.