The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee

University of Kansas, Arthritis Center, Wichita 67214.
Arthritis & Rheumatology (Impact Factor: 7.87). 03/1990; 33(2):160-72.
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ABSTRACT To 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 greater than or equal to 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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Available from: Fred Wolfe, Oct 16, 2014
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    • "The inclusion criteria included age 18 years or older, an FMS diagnosis after a physical assessment by an evaluating rheumatologist (B.W.), and the meeting of either the 1990 or the 2010 American College of Rheumatology (ACR) criteria for FMS. The 1990 ACR criteria required the selfreport of widespread pain in all four quadrants of the body that had persisted for at least 3 months, exhibition of 11/18 tender points on an examination, and the lack of any other reasonable explanation for the symptoms (Wolfe et al., 1990). In 2010, the ACR published preliminary diagnostic criteria that included subjective measurements of fatigue, cognitive dysfunction , sleep problems, and other somatic symptoms and removed the need for measuring tender points (Wolfe et al., 2010). "
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    ABSTRACT: Fibromyalgia syndrome (FMS), a chronic musculoskeletal condition characterized by diffuse pain, fatigue, sleep impairment, and cognitive dysfunction, is associated with significant functional disability. Its underlying biological mechanisms are unknown. This study investigated differentially expressed genes between women with FMS and healthy volunteers. Women who met the 1990 or 2010 American College of Rheumatology fibromyalgia criteria were compared to age- and race-matched pain-free healthy women. Peripheral blood samples were collected, and a full genome microarray gene expression analysis was performed. One-way analysis of variance was used to identify differentially expressed genes using the filtering criterion of 1% false discovery rate. Analysis of canonical pathways associated with these genes was performed. Confirmatory quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay verified microarray results. Independent t-tests compared gene and protein expression between groups. Participants were 54 women with FMS and 25 controls. Expression arrays from a subset of women with FMS (n = 29) and controls (n = 20) showed upregulation of 12 genes (>1.8-fold change, p < .05) in the FMS sample. Differentially expressed genes were related to B-cell development, primary immunodeficiency signaling, and mitotic roles of polo-like kinase. CENPK and HSP90AA1 were the most differentially expressed genes (p < .01). Activity of interrelated pathways related to immune response, and homeostasis appears to be relevant to the experience of FMS. Replication and exploration of the relationship between gene expression and symptom severity will help determine clinical relevance of these findings. © The Author(s) 2015.
    Biological Research for Nursing 05/2015; 17(4). DOI:10.1177/1099800415589785 · 1.34 Impact Factor
    • "Report characteristics Rationale Years considered: 1990e2014 1990 is the year that the ACR fibromyalgia classification criteria was published [1] Language: English, Spanish, Portuguese, and Italian To get an extensive search limiting language restrictions Publication status: peer reviewed articles, doctoral theses, and reports "
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    ABSTRACT: Although sleep complaints are often reported in patients with fibromyalgia syndrome (FMS), there is no conclusive evidence that these complaints represent symptomatic disorders of sleep physiology. Thus, the question of the role of sleep disturbances as an etiological or maintenance factor in FMS remains open. This study identifies the subjective and objective characteristics of sleep disturbances in adult women diagnosed with FMS. We carried out a systematic review of publications since 1990, the publication year of the American College of Rheumatology criteria of FMS. We selected empirical studies comparing sleep characteristics of adult women with FMS and healthy women or women with rheumatic diseases. We identified 42 articles. Patients with FMS were more likely to exhibit sleep complaints and also a less efficient, lighter and fragmented sleep. The evidence of a FMS signature on objective measures of sleep is inconsistent, however, as the majority of studies lack statistical power. Current evidence cannot confirm the role played by sleep physiology in the pathogenesis or maintenance of FMS symptoms; nonetheless, it is clear that sleep disturbances are present in this syndrome.
    Sleep Medicine Reviews 04/2015; 21:86-99. DOI:10.1016/j.smrv.2014.09.001 · 9.14 Impact Factor
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    • "Thirty-six sedentary middle-aged women volunteered to participate in the study, 20 of which were recruited from a Rheumatology Ward and had previously been diagnosed with FM (according to the American College of Rheumatology 1990's criteria (Wolfe et al., 1990)). The control group was composed of 16, age and BMI-matched, control women invited from the local community. "
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    ABSTRACT: Fibromyalgia is a chronic pain condition, which involves reduced range of motion. This leads to gait changes and high incidence of falls. The understanding of the gait patterns in subjects with fibromyalgia and their relationship with falls may be useful when designing intervention programs. The purpose of this study was to evaluate the range of motion of the hip and ankle joints during gait in women with and without fibromyalgia. Further, we determined the relationship between joint range of motion and falls in this population. Middle-aged women (16 with fibromyalgia and 16 as control group) were recruited. Pain intensity, physical activity level, and fall prevalence were assessed. Three dimensional gait analysis provided temporal and joint kinematic variables. In general, hip and ankle range of motion were similar between groups, except that fibromyalgia group showed higher plantar flexion during toe-off (P<0.05) and reduced dorsiflexion during stance phase (P<0.05). Additionally, in the fibromyalgia group the higher number of falls was correlated to reduced dorsiflexion during stance phase. This limitation in dorsiflexion was related to longer length of time with fibromyalgia symptoms. Women with fibromyalgia showed a higher number of falls, reduced dorsiflexion during stance phase, and increased plantar flexion during toe-off. Also, the higher number of falls reported in the fibromyalgia group was related to reduced dorsiflexion during stance phase, which was correlated to a longer length of time living with fibromyalgia symptoms. These data suggest that improving ankle kinematics in patients with fibromyalgia may help prevent falls and improve mobility. Copyright © 2015. Published by Elsevier Ltd.
    Clinical Biomechanics 03/2015; xx(xx):xx. DOI:10.1016/j.clinbiomech.2015.03.026 · 1.88 Impact Factor
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