Fibromyalgia - Diagnosis

Genetics - updated: 11 August 2009

ACR Fibromyalgia Diagnostic Criteria

National Fibromyalgia Research Association

Fibromyalgia is a distinctive syndrome which can be diagnosed with clinical precision. It may occur in the absence (primary fibromyalgia) or presence of other conditions such as rheumatoid arthritis or systemic lupus erythematosus (concomitant fibromyalgia). It is rarely secondary to another disease, in the sense that alleviation of the associated disease also cures the fibromyalgia. It may be confidently diagnosed in patients with widespread musculo-skeletal pain and multiple tender points.

History of widespread pain has been present for at least three months Definition: Pain is considered widespread when all of the following are present:

• Painin both sides of the body
• Painabove and below the waist In addition, axial skeletal pain (cervical spine, anterior chest, thoracic spine or low back pain) must be present. Low back pain is considered lower segment pain.

• Occiput(2) - at the suboccipital muscle insertions.
• Low cervical(2) - at the anterior aspects of the intertransverse spaces at C5-C7.
• Trapezius(2) - at the midpoint of the upper border.
• Supraspinatus(2) - at origins, above the scapula spine near the medial border.
• Secondrib (2) - upper lateral to the second costochondral junction.
• Lateralepicondyle (2) - 2 cm distal to the epicondyles.
• Gluteal(2) - in upper outer quadrants of buttocks in anterior fold of muscle.
• Greatertrochanter (2) - posterior to the trochanteric prominence.
• Knee(2) - at the medial fat pad proximal to the joint line.
• Digital palpation should be performed with an approximate force of 4 kg. A tender point has to be painful at palpation, not just "tender."

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