Flashcards in Fibromyalgia Deck (14):
What should be asked when a patient presents with widespread pain and fatigue?
Variability during day
Systemic features e.g. weight loss night sweats - malignancy
Weight gain, reduced appetite, hair loss - hypothyroidism
Sleep - unrefreshing sleep = fibromyalgia
What is needed for a diagnosis of fibromyalgia?
Chronic widespread pain (over 3 months), both sides of the body, above and below the waist and along the axial spine
What are the differentials for fibromyalgia?
Endocrine - Addison's, hypothyroid, vitamin D deficiency
Infection - Hep C, HIV
Rheum - RA, SLE, PR
Malignancy - lymphoma
What is needed on examination for a diagnosis of fibromyalgia?
11 or more tender points out of 18
Where are the 18 fibromyalgia tender points?
Occiput at nuchal ridge
What can be used to score fibromyalgia?
Widespread pain index
Symptom severity score
What are the ACR criteria for diagnosing fibromyalgia?
WPI of 7 and SS score of 5
WPI 3-6 and SS 9
Symptoms at same intensity for 3 months
No other disorder explains the pain
What investigations should be done for fibromyalgia?
How can fibromyalgia be explained to patients?
A pain condition, not due to inflammation, may be due to chemical changes in the body's pain pathways
What is the treatment for fibromyalgia?
Screen for anxiety and depression
How is severe pain in fibromyalgia treated?
How is severe sleep disturbance in fibromyalgia treated?
Low dose amitriptyline
What is prognosis in fibromyalgia based on?
Yellow flags - biopsychosocial indicators