J Rheum Dis.  2011 Sep;18(3):153-160. 10.4078/jrd.2011.18.3.153.

Newer Diagnostic Criteria of Fibromyalgia and Its Clinical Implications

• Lee SS

• KMID: 2223143
• DOI: http://doi.org/10.4078/jrd.2011.18.3.153

Abstract

Since Smythe and Moldofsky proposed the first modern definition of fibromyalgia (FM), a number of different classification and diagnostic criteria have emerged. Among these criteria, the 1990 American College of Rheumatology (ACR) classification criteria have been the most widely accepted in both research and clinical settings. The 1990 ACR criteria were originally established as inclusion criteria for research purposes and were not intended for clinical diagnosis, but have become the de facto diagnostic criteria in clinical settings. However, an improved clinical case definition for FM, using diagnostic criteria that can be used by both primary care physicians and specialists has been desired for a long time. For this, Wolfe and colleagues developed several sets of diagnostic criteria and their last one received the endorsement of ACR, which is now known as the 2010 ACR diagnostic criteria. Unfortunately, the new criteria have been criticized as being inconsistent, non-specific, and lacking the ability to recognize FM concurrent with other diseases. Further studies are needed to assess the acceptance, reliability, and validity of the new criteria in epidemiologic and clinical studies.

Keyword

Fibromyalgia; Diagnostic; Criteria

MeSH Terms

Fibromyalgia
Humans
Physicians, Primary Care
Rheumatology
Specialization
Wolves

Reference

References

1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombar-dier C, Goldenberg DL, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990; 33:160–72.

2. Goldenberg DL. Diagnosis and differential diagnosis of fibromyalgia. Am J Med. 2009; 122(12 Suppl):S14–21.

3. White KP, Nielson WR, Harth M, Ostbye T, Speechley M. Does the label "fibromyalgia" alter health status, function, and health service utilization? A prospective, with-in-group comparison in a community cohort of adults with chronic widespread pain. Arthritis Rheum. 2002; 47:260–5.

4. Annemans L, Wessely S, Spaepen E, Caekelbergh K, Caubère JP, Le Lay K, et al. Health economic consequ-ences related to the diagnosis of fibromyalgia syndrome. Arthritis Rheum. 2008; 58:895–902.

5. Gowers WR. Lecture on Lumbago: Its Lessons and Analogues: Delivered at the National Hospital for the Paralysed and Epileptic. Br Med J. 1904; 1:117–21.

6. Hench PK. Nonarticular rheumatism, 22nd rheumatism review: review of the American and English literature for the years 1973 and 1974. Arthritis Rheum. 1976; 19:S1081–9.

7. Smythe HA, Moldofsky H. Two contributions to understanding of the "fibrositis" syndrome. Bull Rheum Dis. 1977; 28:928–31.

8. Anch AM, Lue FA, MacLean AW, Moldofsky H. Sleep physiology and psychological aspects of the fibrositis (fibromyalgia) syndrome. Can J Psychol. 1991; 45:179–84.

9. Smythe HA. Nonarticular rheumatism and the fibrositis syndrome. Hollander JL, McCarthy DJ, editors. Arthritis and Allied Conditions. 9th ed.Philadelphia: Lea & Febiger;1979.

10. Yunus M, Masi AT, Calabro JJ, Miller KA, Feigenbaum SL. Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. Semin Arthritis Rheum. 1981; 11:151–71.

11. Yunus MB, Masi AT, Aldag JC. Preliminary criteria for primary fibromyalgia syndrome (PFS): multivariate analysis of a consecutive series of PFS, other pain patients, and normal subjects. Clin Exp Rheumatol. 1989; 7:63–9.

12. Lautenschläger J, Brückle W, Seglias J, Müller W. Localized pressure pain in the diagnosis of generalized ten-domyopathy (fibromyalgia). Z Rheumatol. 1989; 48:132–8.

13. Fitzcharles MA, Boulos P. Inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology (Oxford). 2003; 42:263–7.

14. Clauw DJ, Crofford LJ. Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Best Pract Res Clin Rheumatol. 2003; 17:685–701.

15. Wolfe F. Pain extent and diagnosis: development and val-idation of the regional pain scale in 12,799 patients with rheumatic disease. J Rheumatol. 2003; 30:369–78.

16. Katz RS, Wolfe F, Michaud K. Fibromyalgia diagnosis: a comparison of clinical, survey, and American College of Rheumatology criteria. Arthritis Rheum. 2006; 54:169–76.

17. Wolfe F, Rasker JJ. The Symptom Intensity Scale, fibromyalgia, and the meaning of fibromyalgia-like symptoms. J Rheumatol. 2006; 33:2291–9.

18. Wilke WS. New developments in the diagnosis of fibromyalgia syndrome: say goodbye to tender points? Cleve Clin J Med. 2009; 76:345–52.

19. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010; 62:600–10.

20. Wolfe F. How to use the new American College of Rheumatology fibromyalgia diagnostic criteria. Arthritis Care Res (Hoboken). 2011; 63:1073–4.

21. Vanderschueren S, Van Wambeke P, Morlion B. Fibromyalgia: do not give up the tender point count too easily: comment on the article by Wolfe et al. Arthritis Care Res (Hoboken). 2010; 62:1675.

22. Thompson EN. Diagnostic criteria for fibromyalgia: comment on the article by Wolfe et al. Arthritis Care Res (Hoboken). 2010; 62:1674–5.

23. Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in the general population: sex, pain threshold, and fibromyalgia symptoms. J Rheumatol. 1995; 22:151–6.

24. Yunus MB, Inanici F, Aldag JC, Mangold RF. Fibromyalgia in men: comparison of clinical features with women. J Rheumatol. 2000; 27:485–90.

25. Toda K. Preliminary diagnostic criteria for fibromyalgia should be partially revised: comment on the article by Wolfe et al. Arthritis Care Res (Hoboken). 2011; 63:308–9.

26. Smythe HA. Unhelpful criteria sets for "diagnosis" and "assessment of severity" of fibromyalgia. J Rheumatol. 2011; 38:975–8.

27. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RS, et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol. 2011; 38:1113–22.