Fibromyalgia diagnostic criteria

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

Overview

The most widely accepted set of diagnostic criteria for fibromyalgia was elaborated in 2010 by the Multicenter Criteria Committee of the the American College of Rheumatology. A patient satisfies diagnostic criteria for fibromyalgia if the following 3 conditions are met:

• 1) Widespread pain index (WPI) > 7 and symptom severity (SS) scale score >5 or WPI 3–6 and SS scale score >9.
• 2) Symptoms have been present at a similar level for at least 3 months.
• 3) The patient does not have a disorder that would otherwise explain the pain.

Diagnostic Criteria

The most widely accepted set of diagnostic criteria for fibromyalgia was elaborated in 2010 by the Multicenter Criteria Committee of the the American College of Rheumatology.

Criteria

A patient satisfies diagnostic criteria for fibromyalgia if the following 3 conditions are met:

• 1) Widespread pain index (WPI) > 7 and symptom severity (SS) scale score >5 or WPI 3–6 and SS scale score >9.
• 2) Symptoms have been present at a similar level for at least 3 months.
• 3) The patient does not have a disorder that would otherwise explain the pain.

Ascertainment

1) WPI: note the number areas in which the patient has had pain over the last week. In how many areas has the patient had pain?

• Score will be between 0 and 19.
• Shoulder girdle, left Hip (buttock, trochanter), left Jaw, left Upper back, Shoulder girdle, right Hip (buttock, trochanter), right Jaw, right Lower back, Upper arm, left Upper leg, left Chest Neck, Upper arm, right Upper leg, right Abdomen, Lower arm, left Lower leg, left, Lower arm, right Lower leg, right

2) SS scale score:

• Fatigue
• Waking unrefreshed
• Cognitive symptoms

For the each of the 3 symptoms above, indicate the level of severity over the past week using the following scale:

• 0 = no problem
• 1 = slight or mild problems, generally mild or intermittent
• 2 = moderate, considerable problems, often present and/or at a moderate level
• 3 = severe: pervasive, continuous, life-disturbing problems

Considering somatic symptoms in general, indicate whether the patient has:

• 0 = no symptoms
• 1 = few symptoms
• 2 = moderate number of symptoms
• 3 = Severe symptoms

The SS scale score is the sum of the severity of the 3 symptoms (fatigue, waking unrefreshed, cognitive symptoms) plus the extent (severity) of somatic symptoms in general. The final score is between 0 and 12.