Fibromyalgia syndrome: under-, over- and misdiagnosis, 2019, Hauser et al

Andy · Feb 16, 2019

Abstract
Fibromyalgia syndrome (FM) is an enigma. During the past three decades, with the gradual acceptance of the validity of FM, it is variously under-, over and misdiagnosed. Evidence-based interdisciplinary guidelines have suggested a comprehensive clinical assessment to avoid this diagnostic conundrum.

Every patient with chronic pain should be screened for chronic widespread pain (pain in four of five body regions) (CWP). Those with CWP should be screened for presence of additional major symptoms of FM: unrefreshed sleep and fatigue. A complete medical (including drug) history and complete physical examination is mandatory in the evaluation of a patient with CWP in order to consolidate the diagnosis of FM or identify features that may point to some other condition that may have a presentation similar to FM. Limited simple laboratory testing is recommended to screen for possible other diseases. The 2016 criteria may be used to further confirm the clinical diagnosis of FM. In consideration of the differential diagnosis of FM, attention should be paid to the presence of other chronic overlapping pain conditions and of mental disorders.

FM as a stand alone diagnosis is however rare, as most patients with FM meet criteria for other chronic overlapping pain conditions or mental disorders. The severity of FM should be assessed in order to direct treatment approaches and help inform the likely outcome for an individual patient.
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Abstract only at https://www.ncbi.nlm.nih.gov/pubmed/30747096?dopt=Abstract

Peter Trewhitt · Feb 16, 2019

"FM as a stand alone diagnosis is however rare, as most patients with FM meet criteria for other chronic overlapping pain conditions or mental disorders"

This raises so many questions, but one worries that like ME too many people use it as an excuse to take the condition less seriously or even question its 'reality'.

[added - especially as there may be similar over and under diagnosis of the other conditions. ]

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Fibromyalgia syndrome: under-, over- and misdiagnosis, 2019, Hauser et al

Andy Committee Member

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Fibromyalgia syndrome: under-, over- and misdiagnosis, 2019, Hauser et al

Andy Committee Member

Peter Trewhitt Senior Member (Voting Rights)

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