II. Background

  1. Replaces Tender Points in the diagnosis of Fibromyalgia as of 2010

III. Criteria

  1. Instructions
    1. Part 1: Patient checks boxes on a diagram of a person from back)
    2. Parts 2 and 3: Questions answered without diagram
  2. Part 1: Over the last 7 days, indicate the areas where you have had pain or tenderness
    1. See Tender Points
    2. Neck
    3. Upper Back
    4. Chest or Breast
    5. Abdomen
    6. Lower Back
    7. Left jaw
    8. Left Shoulder
    9. Left upper arm
    10. Left lower arm
    11. Left hip
    12. Left upper leg
    13. Left lower leg
    14. Right jaw
    15. Right Shoulder
    16. Right upper arm
    17. Right lower arm
    18. Right hip
    19. Right upper leg
    20. Right lower leg
  3. Part 2: Over the last 7 days, rate your symptoms based on the following scale
    1. Rating scale
      1. Points 0: No problem
      2. Points 1: Slight or mild
      3. Points 2: Moderate (considerable problems)
      4. Points 3: Severe (life-disturbing problems)
    2. Questions
      1. Fatigue
      2. Trouble thinking or remembering
      3. Waking up tired or unrefreshed
  4. Part 3: Over the last 6 months, have you had any of the following symptoms
    1. Score 1 for 1-10 positive, 2 for 11-24 positive or 3 for 25 or more
    2. Fever
    3. Depressed Mood
    4. Insomnia
    5. Nervousness
    6. Hair Loss
    7. Headache
    8. Seizures
    9. Thinking or memory problem
    10. Numbness of tingling
    11. Dizziness
    12. Fatigue
    13. Hearing problems
    14. Ringing in the ears (Tinnitus)
    15. Blurred Vision
    16. Dry Eyes
    17. Dry Mouth
    18. Oral Ulcers
    19. Shortness of Breath
    20. Chest Pain
    21. Heartburn
    22. Pain in upper Abdomen
    23. Pain or cramps in the lower Abdomen
    24. Nausea
    25. Vomiting
    26. Diarrhea
    27. Constipation
    28. Loss of appetite
    29. Loss or change in taste
    30. Irritable Bowel Syndrome
    31. Bladder spasms
    32. Frequent urination
    33. Painful urination
    34. Easy Bruising
    35. Hives
    36. Itching
    37. Rash
    38. Sun sensitivity
    39. Raynaud Phenomenon
    40. Muscle pain
    41. Muscle Weakness

IV. Scoring

  1. Widespread Pain Index (WPI)
    1. Part 1: Total the number of areas of tenderness or pain (out of 19 possible)
  2. Symptom Score (SS)
    1. Total the points from parts 2 and 3 (out of 12 possible)
    2. Part 2: Total the number of points from the 3 questions (assign 0-3 points for each of the 3 questions)
    3. Part 3: Assign 1 point for each of the 3 questions that are positive

V. Interpretation: Diagnosis of Fibromyalgia

  1. Criteria 1
    1. Widespread Pain Index (WPI): 7 of 19 and
    2. Symptom Score (SS): 5 of 12
  2. Criteria 2
    1. Widespread Pain Index (WPI): 3-6 of 19 and
    2. Symptom Score (SS): 9 of 12

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Ontology: Fibromyalgia (C0016053)

Definition (MEDLINEPLUS)

Fibromyalgia is a disorder that causes muscle pain and fatigue. People with fibromyalgia have "tender points" on the body. Tender points are specific places on the neck, shoulders, back, hips, arms, and legs. These points hurt when pressure is put on them.

People with fibromyalgia may also have other symptoms, such as

  • Trouble sleeping
  • Morning stiffness
  • Headaches
  • Painful menstrual periods
  • Tingling or numbness in hands and feet
  • Problems with thinking and memory (sometimes called "fibro fog")

No one knows what causes fibromyalgia. Anyone can get it, but it is most common in middle-aged women. People with rheumatoid arthritis and other autoimmune diseases are particularly likely to develop fibromyalgia. There is no cure for fibromyalgia, but medicine can help you manage your symptoms. Getting enough sleep, exercising, and eating well may also help.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

Definition (NCI) Inflammation and fibrous degeneration of a muscle.
Definition (NCI) A chronic disorder of unknown etiology characterized by pain, stiffness, and tenderness in the muscles of neck, shoulders, back, hips, arms, and legs. Other signs and symptoms include headaches, fatigue, sleep disturbances, and painful menstruation.
Definition (NCI_FDA) Inflammation and fibrous degeneration of a muscle.
Definition (MSH) A common nonarticular rheumatic syndrome characterized by myalgia and multiple points of focal muscle tenderness to palpation (trigger points). Muscle pain is typically aggravated by inactivity or exposure to cold. This condition is often associated with general symptoms, such as sleep disturbances, fatigue, stiffness, HEADACHES, and occasionally DEPRESSION. There is significant overlap between fibromyalgia and the chronic fatigue syndrome (FATIGUE SYNDROME, CHRONIC). Fibromyalgia may arise as a primary or secondary disease process. It is most frequent in females aged 20 to 50 years. (From Adams et al., Principles of Neurology, 6th ed, p1494-95)
Definition (PSY) A common nonarticular rheumatic condition that is characterized by muscle pain, tenderness, and stiffness.
Definition (CSP) an acute, subacute, or chronic painful state of muscles, subcutaneous tissues, ligaments, tendons, or fasciae caused by a number of agents such as trauma, strain, occupation, exposure, posture, infection, or arthritis.
Concepts Disease or Syndrome (T047)
MSH D005356
ICD10 M79.7 , M79.1
SnomedCT 1304004, 203101004, 203082005, 203111006, 247365004, 13612005, 156727006, 268107007, 203138004, 24693007, 56557000, 203102006
English Fibromyalgias, Fibrositides, Fibrositis, Muscular Rheumatism, Rheumatism, Muscular, Diffuse myofascial pain synd, Fibrositis unspecified, MPDS-Myofac pain dysfunct syn, Myofac pain dysfunct syndrome, Myofascial pain dysfunct syn, Myofascial pain dysfunction syndrome, myofascial pain dysfunction syndrome, MPD syndrome, muscular rheumatism, fibrositis, fibromyalgia (diagnosis), fibromyalgia, fibrositis (diagnosis), Fibromyalgia syndrome, Diffuse Myofascial Pain Syndrome, Myofascial Pain Syndrome, Diffuse, Fibromyalgia Fibromyositis Syndrome, Fibromyalgia-Fibromyositis Syndrome, Fibromyalgia-Fibromyositis Syndromes, Fibromyositis Fibromyalgia Syndrome, Fibromyositis-Fibromyalgia Syndrome, Fibromyositis-Fibromyalgia Syndromes, Syndrome, Fibromyalgia-Fibromyositis, Syndrome, Fibromyositis-Fibromyalgia, Syndromes, Fibromyalgia-Fibromyositis, Syndromes, Fibromyositis-Fibromyalgia, Fibromyalgia [Disease/Finding], fibromyalgia (FM), fibromyalgia syndrome, pain syndrome myofascial, syndrome fibromyalgia, fibromyalgias, fms, mpd syndrome, fibromyalgia (FMS), Fibromyalgia Syndrome, fibromyositis fibromyalgia syndrome, FMS, Fibrositis unspecified (disorder), Fibromyalgia (finding), Fibromyalgia (disorder), Fibromyositis NOS (disorder), Fibrositis NOS, FIBROMYOSITIS, Fibromyositis, Diffuse myofascial pain syndrome, MPDS - Myofacial pain dysfunction syndrome, Myofacial pain dysfunction syndrome, Myofascial pain syndrome, Muscular rheumatism, Fibromyositis (disorder), Fibrositis (disorder), Muscular rheumatism (disorder), fibromyositis, Fibromyositis, NOS, Fibrositis, NOS, Fibromyalgia, NOS, Fibromyalgia -RETIRED-, Fibromyalgia [Ambiguous], Fibromyalgia, Fibromyositis NOS
Dutch fibrositis, fibromyalgiesyndroom, fibromyositis, spier reumatisme, fibromyalgie, Fibromyalgie, Fibrositis, Myofasciaal pijnsyndroom, Spierreuma, Wekedelenreuma
French Syndrome fibromyalgique, Fibrosite, Rhumatisme musculaire, Fibromyalgie, Fibro-myosite, Fibromyosite, Polyenthésopathie, Syndrome de la douleur chronique myofasciale, Syndrome polyalgique diffus
German Fibromyalgiesyndrom, Fibromyositis, Fibromyalgie, Fibrositis, Diffuses myofasziales Schmerzsyndrom, Muskelrheumatismus, Rheumatismus, muskulärer
Italian Fibromiosite, Sindrome fibromialgica, Fibrosite, Reumatismo muscolare, Sindrome dolorosa miofasciale diffusa, Fibromialgia
Portuguese Síndrome de fibromialgia, Reumatismo muscular, Fibromiosite, Síndrome da Dor Miofascial Difusa, Fibromialgia, Fibrosite, Reumatismo Muscular
Spanish Fibromiositis, Reumatismo muscular, Síndrome de fibromialgia, Síndrome de Dolor Miofascial Difuso, fibromiositis, SAI, fibromiositis, SAI (trastorno), fibrositis, no especificada (trastorno), fibromialgia - RETIRADO - (concepto no activo), fibrositis, no especificada, fibromialgia - RETIRADO -, fibromialgia, no especificada (trastorno), fibromialgia, no especificada, fibromialgia, fibromiositis (trastorno), fibromiositis, fibrositis (trastorno), fibrositis, reumatismo muscular (trastorno), reumatismo muscular, síndrome de dolor miofascial, Fibromialgia, Fibrositis, Reumatismo Muscular
Japanese 線維筋炎, 線維筋痛, 線維筋痛症候群, 結合織炎, センイキンツウショウコウグン, センイキンツウ, ケツゴウシキエン, センイキンエン, キンニクリウマチ, 筋肉リウマチ, 線維筋痛症, 筋リウマチ, 結合組織炎, リウマチ-筋肉
Swedish Fibromyalgi
Czech fibromyalgie, Fibrozitida, Fibromyalgie, Svalový revmatismus, Syndrom fibromyalgie, Fibromyozitida, fibrositis, fibromyalgický syndrom, svalový revmatismus, fibrozitida, myofasciální bolestivý dysfunkční syndrom
Finnish Fibromyalgia
Russian FIBROMIALGIIA, FIBROZIT, REVMATIZM MYSHECHNYI, РЕВМАТИЗМ МЫШЕЧНЫЙ, ФИБРОЗИТ, ФИБРОМИАЛГИЯ
Korean 섬유근육통
Croatian FIBROMIALGIJA
Polish Zapalenie tkanki łącznej włóknistej, Fibromialgia, Reumatyzm mięśniowy
Hungarian Fibromyalgia syndroma, Fibromyositis, Fibrositis, Muscularis rheumatismus, Fibromyalgia
Norwegian Fibromyalgi, Kronisk muskelsmerte syndrom, Fibrositt, Myofascielle smerter, Myofibrositt, Fibromyositt