Differentiating Fibromyalgia from other diseases: Difference between revisions
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==Overview== | ==Overview== | ||
Fibromyalgia must be differentiated from other diseases that present with [[pain]], [[fatigue]] and [[Insomnia|sleep disturbance]], and symptoms of cognitive dysfunction and [[psychiatric disease]] such as [[rheumatoid arthritis]], [[SLE]], [[chronic fatigue syndrome]], [[spondyloarthritis]], [[polymyalgia rheumatica]].<ref name="pmid15547167">{{cite journal |vauthors=Goldenberg DL, Burckhardt C, Crofford L |title=Management of fibromyalgia syndrome |journal=JAMA |volume=292 |issue=19 |pages=2388–95 |year=2004 |pmid=15547167 |doi=10.1001/jama.292.19.2388 |url=}}</ref><ref name="pmid24737367">{{cite journal |vauthors=Clauw DJ |title=Fibromyalgia: a clinical review |journal=JAMA |volume=311 |issue=15 |pages=1547–55 |year=2014 |pmid=24737367 |doi=10.1001/jama.2014.3266 |url=}}</ref><ref name="pmid26445775">{{cite journal |vauthors=Borchers AT, Gershwin ME |title=Fibromyalgia: A Critical and Comprehensive Review |journal=Clin Rev Allergy Immunol |volume=49 |issue=2 |pages=100–51 |year=2015 |pmid=26445775 |doi=10.1007/s12016-015-8509-4 |url=}}</ref><ref name="pmid23775553">{{cite journal |vauthors=Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, Henningsen P |title=[Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines] |language=German |journal=Z Psychosom Med Psychother |volume=59 |issue=2 |pages=132–52 |year=2013 |pmid=23775553 |doi=10.13109/zptm.2013.59.2.132 |url=}}</ref><ref name="pmid19050952">{{cite journal |vauthors=Eich W, Häuser W, Friedel E, Klement A, Herrmann M, Petzke F, Offenbächer M, Schiltenwolf M, Sommer C, Tölle T, Henningsen P |title=[Definition, classification and diagnosis of fibromyalgia syndrome] |language=German |journal=Z Rheumatol |volume=67 |issue=8 |pages=665–6, 668–72, 674–6 |year=2008 |pmid=19050952 |doi=10.1007/s00393-008-0404-4 |url=}}</ref> | Fibromyalgia must be differentiated from other diseases that present with [[pain]], [[fatigue]] and [[Insomnia|sleep disturbance]], and symptoms of cognitive dysfunction and [[psychiatric disease]] such as [[rheumatoid arthritis]], [[SLE]], [[chronic fatigue syndrome]], [[spondyloarthritis]], and [[polymyalgia rheumatica]].<ref name="pmid15547167">{{cite journal |vauthors=Goldenberg DL, Burckhardt C, Crofford L |title=Management of fibromyalgia syndrome |journal=JAMA |volume=292 |issue=19 |pages=2388–95 |year=2004 |pmid=15547167 |doi=10.1001/jama.292.19.2388 |url=}}</ref><ref name="pmid24737367">{{cite journal |vauthors=Clauw DJ |title=Fibromyalgia: a clinical review |journal=JAMA |volume=311 |issue=15 |pages=1547–55 |year=2014 |pmid=24737367 |doi=10.1001/jama.2014.3266 |url=}}</ref><ref name="pmid26445775">{{cite journal |vauthors=Borchers AT, Gershwin ME |title=Fibromyalgia: A Critical and Comprehensive Review |journal=Clin Rev Allergy Immunol |volume=49 |issue=2 |pages=100–51 |year=2015 |pmid=26445775 |doi=10.1007/s12016-015-8509-4 |url=}}</ref><ref name="pmid23775553">{{cite journal |vauthors=Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, Henningsen P |title=[Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines] |language=German |journal=Z Psychosom Med Psychother |volume=59 |issue=2 |pages=132–52 |year=2013 |pmid=23775553 |doi=10.13109/zptm.2013.59.2.132 |url=}}</ref><ref name="pmid19050952">{{cite journal |vauthors=Eich W, Häuser W, Friedel E, Klement A, Herrmann M, Petzke F, Offenbächer M, Schiltenwolf M, Sommer C, Tölle T, Henningsen P |title=[Definition, classification and diagnosis of fibromyalgia syndrome] |language=German |journal=Z Rheumatol |volume=67 |issue=8 |pages=665–6, 668–72, 674–6 |year=2008 |pmid=19050952 |doi=10.1007/s00393-008-0404-4 |url=}}</ref> | ||
==Differentiating Fibromyalgia from other Diseases== | ==Differentiating Fibromyalgia from other Diseases== | ||
[[Fibromyalgia]] must be differentiated from other diseases that present with [[pain]], [[fatigue]] and [[Insomnia|sleep disturbance]], and symptoms of cognitive dysfunction and [[psychiatric disease]] such as [[rheumatoid arthritis]], [[SLE]], [[chronic fatigue syndrome]], [[spondyloarthritis]], [[polymyalgia rheumatica]].<ref name="pmid15547167">{{cite journal |vauthors=Goldenberg DL, Burckhardt C, Crofford L |title=Management of fibromyalgia syndrome |journal=JAMA |volume=292 |issue=19 |pages=2388–95 |year=2004 |pmid=15547167 |doi=10.1001/jama.292.19.2388 |url=}}</ref><ref name="pmid24737367">{{cite journal |vauthors=Clauw DJ |title=Fibromyalgia: a clinical review |journal=JAMA |volume=311 |issue=15 |pages=1547–55 |year=2014 |pmid=24737367 |doi=10.1001/jama.2014.3266 |url=}}</ref><ref name="pmid26445775">{{cite journal |vauthors=Borchers AT, Gershwin ME |title=Fibromyalgia: A Critical and Comprehensive Review |journal=Clin Rev Allergy Immunol |volume=49 |issue=2 |pages=100–51 |year=2015 |pmid=26445775 |doi=10.1007/s12016-015-8509-4 |url=}}</ref><ref name="pmid23775553">{{cite journal |vauthors=Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, Henningsen P |title=[Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines] |language=German |journal=Z Psychosom Med Psychother |volume=59 |issue=2 |pages=132–52 |year=2013 |pmid=23775553 |doi=10.13109/zptm.2013.59.2.132 |url=}}</ref><ref name="pmid19050952">{{cite journal |vauthors=Eich W, Häuser W, Friedel E, Klement A, Herrmann M, Petzke F, Offenbächer M, Schiltenwolf M, Sommer C, Tölle T, Henningsen P |title=[Definition, classification and diagnosis of fibromyalgia syndrome] |language=German |journal=Z Rheumatol |volume=67 |issue=8 |pages=665–6, 668–72, 674–6 |year=2008 |pmid=19050952 |doi=10.1007/s00393-008-0404-4 |url=}}</ref> | [[Fibromyalgia]] must be differentiated from other diseases that present with [[pain]], [[fatigue]] and [[Insomnia|sleep disturbance]], and symptoms of cognitive dysfunction and [[psychiatric disease]] such as [[rheumatoid arthritis]], [[SLE]], [[chronic fatigue syndrome]], [[spondyloarthritis]], and [[polymyalgia rheumatica]].<ref name="pmid15547167">{{cite journal |vauthors=Goldenberg DL, Burckhardt C, Crofford L |title=Management of fibromyalgia syndrome |journal=JAMA |volume=292 |issue=19 |pages=2388–95 |year=2004 |pmid=15547167 |doi=10.1001/jama.292.19.2388 |url=}}</ref><ref name="pmid24737367">{{cite journal |vauthors=Clauw DJ |title=Fibromyalgia: a clinical review |journal=JAMA |volume=311 |issue=15 |pages=1547–55 |year=2014 |pmid=24737367 |doi=10.1001/jama.2014.3266 |url=}}</ref><ref name="pmid26445775">{{cite journal |vauthors=Borchers AT, Gershwin ME |title=Fibromyalgia: A Critical and Comprehensive Review |journal=Clin Rev Allergy Immunol |volume=49 |issue=2 |pages=100–51 |year=2015 |pmid=26445775 |doi=10.1007/s12016-015-8509-4 |url=}}</ref><ref name="pmid23775553">{{cite journal |vauthors=Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, Henningsen P |title=[Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines] |language=German |journal=Z Psychosom Med Psychother |volume=59 |issue=2 |pages=132–52 |year=2013 |pmid=23775553 |doi=10.13109/zptm.2013.59.2.132 |url=}}</ref><ref name="pmid19050952">{{cite journal |vauthors=Eich W, Häuser W, Friedel E, Klement A, Herrmann M, Petzke F, Offenbächer M, Schiltenwolf M, Sommer C, Tölle T, Henningsen P |title=[Definition, classification and diagnosis of fibromyalgia syndrome] |language=German |journal=Z Rheumatol |volume=67 |issue=8 |pages=665–6, 668–72, 674–6 |year=2008 |pmid=19050952 |doi=10.1007/s00393-008-0404-4 |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
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* [[Rheumatoid nodules]] | * [[Rheumatoid nodules]] | ||
| | | | ||
* [[Rheumatoid factor|RF]] or anti-cyclic citrullinated protein (CCP) | * [[Rheumatoid factor|RF]] or [[Anti-citrullinated protein antibody|anti-cyclic citrullinated protein (CCP) antibody]] is positive. | ||
* Markers of systemic inflammation ([[ESR]], [[CRP]]) are typically elevated. | * Markers of systemic inflammation ([[ESR]], [[CRP]]) are typically elevated. | ||
| Line 63: | Line 63: | ||
* Negative [[RF]] | * Negative [[RF]] | ||
* Bamboo spine on | * [[Bamboo spine]] on [[x-ray]] | ||
|- | |- | ||
|[[Polymyalgia rheumatica]] | |[[Polymyalgia rheumatica]] | ||
| Line 70: | Line 70: | ||
* Generalized [[stiffness]] | * Generalized [[stiffness]] | ||
| | | | ||
* An elevated [[erythrocyte sedimentation rate]] ([[ESR]]) OR [[C-reactive protein]] (CRP | * An elevated [[erythrocyte sedimentation rate]] ([[ESR]]) OR [[C-reactive protein]] (CRP) | ||
* Response to [[corticosteroids]] | * Response to [[corticosteroids]] | ||
|- | |- | ||
| Line 79: | Line 79: | ||
* Older at onset | * Older at onset | ||
| | | | ||
* X ray of the involved joints demonstrate degenerative changes | * [[X-ray]] of the involved joints demonstrate degenerative changes | ||
|- | |- | ||
|[[Hypothyroidism]] | |[[Hypothyroidism]] | ||
| Line 93: | Line 93: | ||
*[[Rash]] | *[[Rash]] | ||
| | | | ||
*Muscle biopsy confirms the diagnosis | *[[Muscle biopsy]] confirms the diagnosis | ||
*Elevated [[CPK|CPK enzyme]] | *Elevated [[CPK|CPK enzyme]] | ||
|- | |- | ||
Revision as of 13:13, 3 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Fibromyalgia must be differentiated from other diseases that present with pain, fatigue and sleep disturbance, and symptoms of cognitive dysfunction and psychiatric disease such as rheumatoid arthritis, SLE, chronic fatigue syndrome, spondyloarthritis, and polymyalgia rheumatica.[1][2][3][4][5]
Differentiating Fibromyalgia from other Diseases
Fibromyalgia must be differentiated from other diseases that present with pain, fatigue and sleep disturbance, and symptoms of cognitive dysfunction and psychiatric disease such as rheumatoid arthritis, SLE, chronic fatigue syndrome, spondyloarthritis, and polymyalgia rheumatica.[1][2][3][4][5]
| Disease | Differentiating signs and symptoms | Diagnostic findings |
|---|---|---|
| Fibromyalgia |
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| Rheumatoid arthritis |
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| SLE |
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| Chronic fatigue syndrome | Fatigue plus 4 of the following symptoms:
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| Spondyloarthritis |
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| Polymyalgia rheumatica |
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| Osteoarthritis |
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| Hypothyroidism |
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| Myopathaies (polymyositis and dermatomyositis) |
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| Neuropathy |
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References
- ↑ 1.0 1.1 Goldenberg DL, Burckhardt C, Crofford L (2004). "Management of fibromyalgia syndrome". JAMA. 292 (19): 2388–95. doi:10.1001/jama.292.19.2388. PMID 15547167.
- ↑ 2.0 2.1 Clauw DJ (2014). "Fibromyalgia: a clinical review". JAMA. 311 (15): 1547–55. doi:10.1001/jama.2014.3266. PMID 24737367.
- ↑ 3.0 3.1 Borchers AT, Gershwin ME (2015). "Fibromyalgia: A Critical and Comprehensive Review". Clin Rev Allergy Immunol. 49 (2): 100–51. doi:10.1007/s12016-015-8509-4. PMID 26445775.
- ↑ 4.0 4.1 Häuser W, Burgmer M, Köllner V, Schaefert R, Eich W, Hausteiner-Wiehle C, Henningsen P (2013). "[Fibromyalgia syndrome as a psychosomatic disorder - diagnosis and therapy according to current evidence-based guidelines]". Z Psychosom Med Psychother (in German). 59 (2): 132–52. doi:10.13109/zptm.2013.59.2.132. PMID 23775553.
- ↑ 5.0 5.1 Eich W, Häuser W, Friedel E, Klement A, Herrmann M, Petzke F, Offenbächer M, Schiltenwolf M, Sommer C, Tölle T, Henningsen P (2008). "[Definition, classification and diagnosis of fibromyalgia syndrome]". Z Rheumatol (in German). 67 (8): 665–6, 668–72, 674–6. doi:10.1007/s00393-008-0404-4. PMID 19050952.