The american college of rheumatology 1990 criteria for the classification of fibromyalgia

Wiley - Tập 33 Số 2 - Trang 160-172 - 1990
Frederick Wolfe1, H A Smythe2, Muhammad B. Yunus3, Robert M. Bennett4, Claire Bombardier2, Don L. Goldenberg5, Peter Tugwell6, Stephen Campbell4, Moshe Abeles7, Patricia Clark6, Adel G. Fam8, Stephen J. Farber9, Justus J. Fiechtner10, Cindy Franklin11, Robert Gatter11, Daniel Hamaty12, J Lessard13, Alan S. Lichtbroun14, Alfonse T. Masi3, Glenn A. McCain15, W. J. Reynolds16, Thomas J. Romano17, I. Jon Russell18, Robert P. Sheon9
1University of Kansas, Wichita, KS
2The Wellesley Hospital, Toronto, Ontario, Canada.
3University of Illinois, Peoria, IL
4Oregon Health & Sciences University, Portland, OR
5Boston University, Boston, MA
6McMaster University, Hamilton, Ontario, Canada
7University of Connecticut, Farmington, CT
8Sunnybrook Medical Centre, Toronto, Ontario, Canada
9Toledo Clinic, Toledo, OH
10University of North Dakota, Fargo, ND
11Center for Arthritis and Back Pain, Willow Grove, PA
12City of Faith, Tulsa, OK
13Grand Forks Clinic, Grand Forks, ND
14Metuchen, NJ
15University Hospital London, Ontario, Canada.
16Toronto Western Hospital, Toronto, Ontario, Canada
17Wheeling Hospital, Wheeling, WV
18University of Texas Health Science Center, San Antonio, TX

Tóm tắt

AbstractTo develop criteria for the classification of fibromyalgia, we studied 558 consecutive patients: 293 patients with fibromyalgia and 265 control patients. Interviews and examinations were performed by trained, blinded assessors. Control patients for the group with primary fibromyalgia were matched for age and sex, and limited to patients with disorders that could be confused with primary fibromyalgia. Control patients for the group with secondary‐concomitant fibromyalgia were matched for age, sex, and concomitant rheumatic disorders. Widespread pain (axial plus upper and lower segment plus left‐ and right‐sided pain) was found in 97.6% of all patients with fibromyalgia and in 69.1% of all control patients. The combination of widespread pain and mild or greater tenderness in ⩾ 11 of 18 tender point sites yielded a sensitivity of 88.4% and a specificity of 81.1%. Primary fibromyalgia patients and secondary‐concomitant fibromyalgia patients did not differ statistically in any major study variable, and the criteria performed equally well in patients with and those without concomitant rheumatic conditions. The newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites. No exclusions are made for the presence of concomitant radiographic or laboratory abnormalities. At the diagnostic or classification level, the distinction between primary fibromyalgia and secondary‐concomitant fibromyalgia (as defined in the text) is abandoned.

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Wiley

Tập 33 Số 2

160-172

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