Diagnosis of Fibromyalgia in General Practice

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Diagnosis of Fibromyalgia in General Practice
Key Take-Away: 

Fibromyalgia (FM) affects nearly 3-6% of the world's total population. This pain condition is often misdiagnosed as it shares common symptoms with other pain conditions. The present study focuses on determining appropriate pain identification criteria to avoid misinterpretation of fibromyalgia pain with different types of musculoskeletal pain.

The chronic pain syndrome FM shares common symptoms with other pain or musculoskeletal syndromes and that is why clinicians find it difficult to diagnose FM.

ABSTRACT: 
Background: 

The chronic pain syndrome FM shares common symptoms with other pain or musculoskeletal syndromes and that is why clinicians find it difficult to diagnose FM.

The prospective cohort study was conducted to compare the characteristics of FM patients with patients suffering from other forms of nonmalignant chronic pain. 33 patients with a working diagnosis of FM were recognized, out of which 26 (78.8%) participated in the study. The included patients were matched by age and gender to a control group (including patients  with other forms of chronic nonmalignant pain).

Methods: 

The 1990 and revised 2010 American College of Rheumatology (ACR) guidelines were referred to initiate standardized physical examinations for FM.

Diagnoses of psychiatric disorders and responses to the Pain Disability Index, Personal Health Questionnaire, Revised Fibromyalgia Impact Questionnaire, and Rapid Estimate Adult Literacy in Medicine were used to compare the groups.

Results: 

Psychiatric disorders observed were depression (44.4%) and anxiety (27.3%).

The prevalence of at least one psychiatric condition was 80.8%, and the only variation (P = 0.002) between the two groups was the mean number of tender points: 5.6 (±4.2) vs. controls 3.2 (±2.2). Only 3 (11.5%) participants with a previous diagnosis of FM met the 1990 ACR diagnostic criteria, increasing to 38.5% when the 2010 criteria were applied; however, 46.1% of controls also met the revised diagnostic criteria.

Conclusion: 

FM is usually misdiagnosed. Therefore, there is a need to re-evaluate and review all patients with a working diagnosis to assure that the most suitable treatment is given.

 

Source:

Pain Med pnx155

Link to the source:

https://academic.oup.com/painmedicine/article-abstract/doi/10.1093/pm/pnx155/3977937/The-Accuracy-of-a-Fibromyalgia-Diagnosis-in?redirectedFrom=fulltext

The original title of the article:

The Accuracy of a Fibromyalgia Diagnosis in General Practice

Authors:

Rosalind Gittins et al.

Exploratory, Fibromyalgia, Nerves, Prospective Cohort Study, Pain Disability Index, Personal Health Questionnaire, Revised Fibromyalgia Impact Questionnaire, Rapid Estimate Adult Literacy
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