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.
Source: PubMed

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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    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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    ABSTRACT: Diagnosis of fibromyalgia (FM), a chronic musculoskeletal pain syndrome characterized by generalized body pain, hyperalgesia and other functional and emotional comorbidities, is a challenging process hindered by symptom heterogeneity and clinical overlap with other disorders. No objective diagnostic method exists at present. The aim of this study was to identify changes in miRNA expression profiles (miRNome) of these patients for the development of a quantitative diagnostic method of FM. In addition, knowledge of FM patient miRNomes should lead to a deeper understanding of the etiology and/or symptom severity of this complex disease. Genome-wide expression profiling of miRNAs was assessed in Peripheral Blood Mononuclear Cells (PBMCs) of FM patients (N=11) and population-age-matched controls (N=10) using human v16-miRbase 3D-Gene microarrays (Toray Industries, Japan). Selected miRNAs from the screen were further validated by RT-qPCR. Participating patients were long term sufferers (over 10 years) diagnosed by more than one specialist under 1990 American College of Rheumatology criteria. Microarray analysis of FM patient PBMCs evidenced a marked downregulation of hsa-miR223-3p, hsa-miR451a, hsa-miR338-3p, hsa-miR143-3p, hsa-miR145-5p and hsa-miR-21-5p (4-fold or more). All but the mildest inhibited miRNA, hsa-miR-21-5p, were validated by RT-qPCR. Globally, 20% of the miRNAs analyzed (233/1212) showed downregulation of at least 2-fold in patients. This might indicate a general de-regulation of the miRNA synthetic pathway in FM. No significant correlations between miRNA inhibition and FM cardinal symptoms could be identified. However, the patient with the lowest score for mental fatigue coincided with the mildest inhibition in four of the five miRNAs associated with the FM-group. We propose a signature of five strikingly downregulated miRNAs (hsa-miR223-3p, hsa-miR451a, hsa-miR338-3p, hsa-miR143-3p and hsa-miR145-5p) to be used as biomarkers of FM. Validation in larger study groups is required before the results can be transferred to the clinic.
    PLoS ONE 01/2015; 10(3):e0121903. DOI:10.1371/journal.pone.0121903 · 3.53 Impact Factor
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