Question:
It has always been my understanding that in order to receive a diagnosis of
Fibromyalgia and to have it considered accurate that a person must undergo
a constellation of tests (all which come back negative), that they have a
minimum of 11 or 18 trigger points active (as outlined by the American
Arthritis whatever), that the person have been experiencing wide spread
unrelenting pain for a long period of time ... and that the diagnosis must
be made by a Rheumatologist.
And yet ... there seems to be so many people are receiving a FMS diagnosis
without having seen a Rheumatologist nor undergone the battery of tests.
Have I missed a medical update which permits the diagnosis of FMS by any
physician, and have it recognized as accurate?
This concerns me .... a lot. Since being diagnosed and after having read
everything I could on FM in the following 6 months (admittedly not so much
in the past year or so) .... I have been contacted by friends or friends and
friends of family just to talk. There have been 6 of these people that
received a diagnosis from someone other than a rheumatologist, and I
suspected from speaking with them for a little while that they did not have
FMS and I urged them to contact their doctor and force him to start testing
for other things. The symptoms all sounded similar to what I am
experiencing ... but the way it affected them was usually so vastly
different that I just felt we were not comparing apples and apples.
In all 6 of those cases ... it was turned out that it was not FMS .... they
received treatments, in some cases an operation, and the symptoms in all 6
have disappeared. Two turned out to have sleep apnea, a couple were blood
disorders - both treatable, another had a "woman's" operation and now she is
fine (she wouldn't tell me exactly what it was), and the last had a section
of an artery replaced that was mostly blocked.
My biggest concern and worry is that there are people out there suffering
with the symptoms of FMS and they nor their doctors (due to lack of testing)
realize it is actually something curable causing it.
Answer:
When doing my research for my disability claim this is what I came across as
far as diagnosing fm.
Diagnostic Criteria
There is no blood or x-ray test to help the doctor determine whether someone
has fibromyalgia. Routine laboratory studies in fibromyalgia are essentially
normal. Sleep studies may show alpha intrusion into delta sleep on EEG
recordings of Stage IV or non-REM sleep in some patients. The EMG is usually
normal. Therefore, the diagnosis of fibromyalgia is made purely on clinical
grounds. In patients with widespread body pain, the diagnosis of
fibromyalgia can be made by identifying trigger point tenderness areas, by
finding no accompanying tissue swelling or inflammation, and by excluding
other medical conditions that can mimic fibromyalgia.
In 1990, the American College of Rheumatology and 28 specialist�s centers
across the United States and Canada participated in a research study which
scientifically established diagnostic criteria that allow the diagnosis of
fibromyalgia to be made with confidence. The criteria are based on details
from patients� medical histories and physical examinations.
The official definition requires that:
? 11 out of the 18 tender points must be present in all four quadrants of
the body � that is, the upper right and left and lower right and left parts
of your body
? You must have had widespread, more-or-less continuous pain for at least
three months.
It is not possible to accurately diagnose fibromyalgia without knowing how
to do a tender point examination. It is not a diagnosis of exclusion.
Although there have been many abnormalities of laboratory and other tests
reported in fibromyalgia, none is sufficiently sensitive or specific to be
useful diagnostically. Therefore, routine laboratory or other studies are
not recommended{16}. Laboratory tests for fibromyalgia are valid only to
rule out other conditions.
