FM is certainly not a new syndrome, as corroborating reports have been published since 1592.9 The term "fibromyalgia" was first used in a review by Hench10 in 1976, although its recognition as a syndrome occurred after the publication of a study by Yunus et al. 2010;62:3488-95. 9 O termo fibromialgia foi cunhado pela primeira vez por uma revisão de Hench 10 em 1976, mas seu reconhecimento como síndrome ocorreu após publicação do trabalho de Yunus et al. Pain Med. Também pode ocorrer insônia, sensação de pernas inquietas antes de dormir e movimentos da perna durante o sono. Aproximadamente, 10% a 30% dos pacientes com esses distúrbios reumatológicos também preenchem os critérios para fibromialgia. Counting and searching for tender points became another reason for discussion because many physicians lacked adequate training to recognize them. In 1990, the American College of Rheumatology (ACR) prepared classification criteria that were accepted by the scientific community,12 substantially helping to homogenize the diagnosis of FM and to promote studies on FM. Wolfe e latri hanno proposto un nuovo sistema diagnostico che integri tutti i sintomi e basato sull'accertamento del dolore diffuso, rilevato attraverso un questionario da compilare e denominato Widespread Pain Index, WPI, che traduciamo con Indice di Dolore Diffuso, riferito alla settimana precedente la compilazione del questionario. J Rheumatol. 1999;26:1570-6. Arthritis Rheum. 2003;17:685-701. The CAP index (total CAP time/non-rapid eye movement (REM) sleep time) is increased in FM and is correlated with the severity of clinical symptoms (tender points) and with the decrease in sleep efficiency, with an increased ratio of non-REM sleep and twice as many awakenings per hour of sleep (B).54. ACR (ACR 1990) - (widespread chronic pain defined by the ACR and pressure stiffness of at least 11/18 tender points). [ Links ], 52 Diaz-Piedra C, Di Stasi LL, Baldwin CM, Buela-Casal G, Catena A. Em que especialista é necessário ir, que exames são necessários e outras informações de utilidade para o diagnóstico de Fibromialgia En ocasiones, los síntomas comienzan después de traumatismos físicos, cirugías, infecciones o estrés psicológico significativo. [ Links ], 3 White KP, Speechley M, Harth M, Ostbye T. Co-existence of chronic fatigue syndrome with fibromyalgia syndrome in the general population: a controlled study. Available at: http://www.cebm.net/index.aspx?o=5653. A tabela de evidência utilizada é a de Oxford Center of Evidence Based Medicine (Oxford Center of Evidence Based Medicine (Levels of Evidence, March 2009)8. A second subgroup showed high values in the mood disorder evaluations, the highest values in the pain catastrophizing scale, and the lowest values of pain control with high levels of pain. Objetivo: Foi identificar os instrumentos e formas de avaliação em pacientes com fibromialgia. Psychosocial stress and anxiety in musculoskeletal pain patients with and without depression. Clin J Pain. The authors declare no conflicts of interest. The risk increased proportionally to the intensity of the sleep problems and with the increase of the patient age group (B).51, Sleep disorders occur in FM regardless of the assessment instrument. Explanation of the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence (Background Document). [ Links ], 6 Gamero Ruiz F, Gabriel Sánchez R, Carbonell Abello J, Tornero Molina J, Sanchez-Magro I. 2010;8:2. Evidence-based clinical practice. [ Links ], 31 Tastekin N, Uzunca K, Sut N, Birtane M, Mercimek OB. Can the 2010 criteria be considered in the diagnosis of FM? 2009;27:42-6. Unas palabras de agradecimiento nunca están de más. Keywords: Fibromyalgia; Pain; Diagnosis; Diagnostic criteria; Guidelines. 1994;85:451-4. Development of a self-reporting tool to obtain a combined index of severity of fibromyalgia (ICAF). • Não há necessidade de confirmação diagnóstica por especialista. (sleep OR fatigue OR mental disorders OR cognitive OR cognition OR stress) AND Fibromyalgia AND (sensitiv*[Title/Abstract] OR sensitivity and specificity[MeSH Terms] OR diagnos*[Title/Abstract] OR diagnosis[MeSH:noexp] OR diagnostic* [MeSH:noexp] OR diagnosis,differential[MeSH:noexp] OR diagnosis[Subheading:noexp]). Authors: Roberto Ezequiel Heymann. O diagnóstico é baseado principalmente na presença de dor generalizada por um período de pelo menos três … Está presente en el 5% de la pobla-ción general adulta (principalmente mujeres). [ Links ], 48 Hau PP, Roger A, Scudds RA, Harth M. An evaluation of mechanically induced neurogenic flare by infrared thermography in fibromyalgia. MÉTODOS: Estudo realizado por meio de análise de ques-tionários com padrão EpiFibro aplicados a 146 mulheres com fibromialgia durante consulta ambulatorial. Motor skills were significantly reduced (an Assessment of Motor and Process Skills score <1.5) in patients with widespread pain and numbers of tender points ≥11 (B).36. Há casos em que os sintomas diminuem consideravelmente, chegando a quase desaparecer, mas há outros em que será necessário fazer controle por toda a vida. However, their administration in outpatient primary care settings becomes impractical due to the time required to fill them out. Após definir os estudos potenciais para sustentação das recomendações, esses foram graduados pela força da evidência e grau de recomendação. 2009;122(Suppl):S14-21. Fibromyalgia AND (exclu* OR differential). [ Links ], Received: [ Links ], 43 Usui C, Hatta K, Aratani S, Yagishita N, Nishioka K, Kanazawa T, et al. The critical evaluations of the cohort studies were performed using the Newcastle-Ottawa Scale (NOS)16 and the cross-sectional studies using Quadas.17. A fibromialgia é um distúrbio crônico de dor centralizada, marcada por maciez muscular generalizada. Of the 2010 ACR patients negative for FM, 32.8% were positive for the widespread pain criterion (B).14, In 2016, a review of the 2010/2011 criteria was proposed to correct classification errors observed in patients with regional pain by adding a complementary criterion of widespread pain (B).25. Clin Exp Rheumatol. 2007;36:339-56. Fibromialgia •A FM representa um espectro de intensidade entre os pacientes, alguns apresentam sintomas leves enquanto outros apresentam extremo sofrimento. 1. J Rheumatol. [ Links ], 54 Rizzi M, Sarzi-Puttini P, Atzeni F, Capsoni F, Andreoli A, Pecis M, et al. Universiteit Gent. Pain. Poucos estudos epidemiológicos foram publicados, no Brasil, sobre essa doença. Más de 65, es indispensable ponerse en contacto con un médico para modificar el tratamiento. Porém, cientistas do mundo inteiro se dedicam ao seu estudo, para melhorar a qualidade de vida daqueles por ela atingidos. Is widespread pain is essential for the diagnosis of FM? [ Links ], 59 Ahles TA, Khan SA, Yunus MB, Spiegel DA, Masi AT. Ann Rheum Dis. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivative License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited and the work is not changed in any way. Influence of distress on 4 measures of tenderness. However, the role of these changes in their pathophysiology is still controversial. There is no scientific evidence to recommend using thermography for the diagnosis of FM. A síndrome da fibromialgia (FM) é uma condição clínica caracterizada por dor crônica generalizada geralmente associada a fadiga, distúrbios do sono e sintomas cognitivos. Além disso, podem surgir outros sintomas como cansaço frequente, distúrbios do sono e sensação de formigamento nas mãos e nos pés, por exemplo. Despite advances in the use of these criteria, many criticisms have appeared over the years, especially regarding overvaluing widespread pain above symptoms such as fatigue, sleep disorders and morning stiffness, among others. Pain Med. However, current evidence does not permit confirmation of the importance of sleep for the pathogenesis and maintenance of FM symptoms, according to Diaz-Pietra (B).52, In polysomnographic assessments, both patients with FM and patients with primary insomnia showed decreased total sleep times and increased latency to persistent sleep and times of awakenings after starting sleeping when compared with normal people. Scotton AS, Fraga RO, Alvarenga MG, Fellet AJ, Juste LM. A demora média do diagnóstico foi de 12,3 meses. comuns da fibromialgia, num período de tempo específico (últimos sete dias)7. Las respuestas que usted proporcionará a este cuestionario permitirán conocer mejor el impacto de su enfermedad sobre su calidad de vida día a día. 1976;19(Suppl):1081-9. 2010;62:600-10. A utilização de questionários de avaliação da qualidade de vida tem sido reconhecida como uma importante área do conhecimento científico no campo da saúde, uma vez que permite uma avaliação mais objectiva de sintomas tão subjectivos, como dor, ansiedade, depressão, entre outros. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. El Test de Fibromialgia de CogniFit consta de una serie de ítems de fácil respuesta que pueden ser cumplimentados por el profesional responsable de la evaluación, o por la propia persona que realiza la valoración de la Fibromialgia. Best Pract Res Clin Rheumatol. Rheumatol Int. Questions without this level of agreement were subjected to new questioning and correction sessions via the Internet until they were accepted by at least 70% of the members. acronym, wherein P corresponds to Patient - with Fibromyalgia; I to intervention - diagnostic criteria or ACR criteria, widespread pain, tender points, sleep disorders, fatigue, thermography; C to Comparison - clinical evaluation and other diagnostic criteria; and O to Outcome - diagnostic accuracy.15 Thus, the descriptors to be used in the search strategies for scientific evidence were obtained. Um com estimulacao cerebral, imagetica e massoterapia (EC+M), outro imagetica e massoterapia (MT) e o … O objetivo deste trabalho foi o de reunir e relacionar a informação mais recente e relevante sobre a fibromialgia. [ Links ], 45 Ammer K, Engelbert B. Reproducibility of the hot spot count in patients with fibromyalgia: an intra and inter-observer comparison. Ela não tem cura, já que é um quadro crônico. Questa valutazione contribuisce a misurare l'impatto della fibromialgia sulla funzionalità fisica ed emozionale, così … [ Links ], 18 Howick J, Chalmers I, Glasziou P, Greenhalgh T, Heneghan C, Liberati A, et al. Arthritis Rheum. [ Links ], 8 Pereira AM, Valim V, Zandonade E, Ciconelli R. Prevalence of musculoskeletal manifestation in the adult Brazilian population: a study using COPCORD questionnaires. 2003;30:567-74. 5. Are sleep disorders, fatigue disorders and cognitive disorders also considered? As questões resultaram em nove recomendações para o diagnóstico da fibromialgia com base nas evidências de literatura e na opinião dos experts que participaram do trabalho. A causa que causa essa condição ainda não é conhecida, mas o envolvimento de determinadas alterações na neurotransmissão tem sido destacado, o que induz uma má interpretação dos estímulos dolorosos. 20. 2008;59:961-7. Esto se conoce como percepción anormal del dolor. The authors proposed that such a finding would result from increased adrenergic sympathetic activity at rest. [ Links ], 66 Poleshuck EL, Bair MJ, Kroenke K, Damush TM, Krebs EE, Giles DE. Las siguientes preguntas tienen como objetivo medir las consecuencias de su fibromialgia sobre su salud. Diagnosis of fibromyalgia syndrome-A comparison of Association of the Medical Scientific Societies in Germany, survey, and American College of Rheumatology criteria. [ Links ], 39 Bigatti SM, Hernandez AM, Cronan TA, Rand KL. Minerva Med. 4. The subjectivity of FM symptoms considerably expands the possibilities of differential diagnosis to be considered by the physician. O questionário descobriu que a fibromialgia estava presente em 143 pacientes (24,4%) com outras doenças inflamatórias reumáticas. [ Links ], 33 Salli A, Yilmaz H, Ugurlu H. The relationship between tender point count and disease severity in patients with primary fibromyalgia. Pain, functional disability, and psychological status: a 12-month study of severity in fibromyalgia. The presence of widespread pain is essential for the diagnosis of patients with suspected FM. Incluyen: síntomas de dolor generalizado crónico por encima y por debajo de la cintura y que afecten a ambos lados del cuerpo. The formulation structure of each question is summarized by the P.I.C.O. "Quando avaliados segundo critérios ACR 90, em primeiro lugar tinha uma sensibilidade de 74,5%, uma especificidade de 80,4%, um valor preditivo positivo de 26,6% e um valor preditivo negativo de 97,1%", os autores confirmados na revista Rheumatology . Conversely, the temperature recovery patterns were similar in both groups.50. Reumatol Clin. Confirmado o diagnóstico de fibromialgia e antes do início da abordagem terapêutica, deve ser efetuada a avaliação inicial, através do Questionário de Impacte da Fibromialgia Revisto (FIQR), versão portuguesa para monitorização e controlo, referente à autoavaliação dos últimos sete dias (Anexo II e Anexo III) (Nível de Evidência 1, Grau de Recomendação A). Fig. Fibromyalgia AND (sensitiv*[Title/Abstract] OR sensitivity and specificity[MeSH Terms] OR diagnos*[Title/Abstract] OR diagnosis[MeSH:noexp] OR diagnostic* [MeSH:noexp] OR diagnosis,differential[MeSH:noexp] OR diagnosis[Subheading:noexp]) Limits: published in the last 3 years Sort by: PublicationDate, 6. Dificuldades co… Should we assess mood disorders in patients with FM? •Problemas com a fibromialgia –Caráter subjetivo dos sintomas –Ausência de um teste diagnóstico (laboratorial ou de imagem) –Resposta modesta ao tratamento Qual Life Res. Oxford Centre for Evidence-Based Medicine. 2012;22:40-4. Evidence collection was performed based on 9 questions regarding the diagnosis of fibromyalgia, structured using the Patient, Intervention or Indicator, Comparison and Outcome (P.I.C.O. Resultados: A perceção de que a Fibromialgia representa uma … 2008;18:45-50. showed that the rheumatologist confirms the clinical diagnosis in 71% cases. Therefore, the diagnosis is often evaluated only based on patient complaints.20, The incidence rates of the presence of tender points at a higher number than 11 were 22.4%, 24.7% and 89.9% in patients with Rheumatoid Arthritis, Osteoarthritis, and FM, respectively, with a linear association between the number of tender points and the Rheumatology Distress Index (RDI) (B).26, Regardless of the diagnostic method used to define FM (clinical or through a questionnaire combining evaluation of regional pain and fatigue), a substantial number of positive diagnoses occurred at tender point counts ranging from 6 to 18, and the diagnosis was strongly negative at values lower than 2-3 (B).21, Patients with FM were identified through tender points (more than 11) with 84% sensitivity and 87% specificity, which provided 84% diagnostic certainty when positive (B).27, Regardless of the FM diagnosis, 70% of elderly patients older than 70 years, with widespread pain, had at least 1 positive tender point, 41.5% had more than 3 tender points, and less than 10% had more than 10 tender points. The WPI of patients diagnosed with FM and with positive 2010 ACR criteria was significantly higher, on average, than that of patients with negative criteria. 2000;29:44-51. Conheça Rev Assoc Med Bras (Portuguese). A fibromialgia (FM) é uma condição caracterizada por dor generalizada, comumente associada a fadiga, distúrbios cogniti-vos, afetivos e do sono (1). Las personas con fibromialgia pueden ser más sensibles al dolor que aquellas que no la tienen. A maioria das pessoas com fibromialgia apresenta sintomas gastrointestinais concomitantes à sintomas somatossensitivos, além de fadiga, distúrbios no sono, memória, humor e cognição. Fibromialgia. Una puntuación de 0 no es compatible con el diagnóstico de fibromialgia (o está curado o está en camino de curarse). There are no consistent data evaluating the use of thermography in patients with FM, and the few published studies fail to support the use of thermography as a diagnostic method for FM. [ Links ], 4 Haq SA, Darmawan J, Islam MN, Uddin MZ, Das BB, Rahman F, et al. J Rheumatol. Sleep Med Rev. Gen Hosp Psychiatry. Certamente não se trata de uma nova síndrome, pois existem relatos compatíveis desde 1592. Revista Brasileira de Medicina 2004 61(12):70-75. 2010;22:548-56. In this study, the authors recommended excluding other diseases that may be confused with FM (B).13, Similarly, Goldenberg DL listed clinical situations that should be part of the differential diagnosis of FM and that may be ruled out through laboratory or imaging tests, citing rheumatoid arthritis, systemic lupus erythematosus, polymyalgia rheumatica, myopathies, ankylosing spondylitis, hypothyroidism, and peripheral neuropathies (D).57, The presence of common symptoms associated with the functional nature of various conditions led Yunus MB into grouping them into so-called central sensitivity syndromes, which include chronic fatigue syndrome, irritable bowel syndrome, migraine, and temporomandibular joint dysfunctions, in addition to FM (B).58, A recent review of the 2010/2011 criteria proposed the validity of the FM diagnosis independent from other diagnoses (B).25. A sua prevalência parece ser de 2 a 8% da população. 1990;33:160-72. Arthritis Care Res (Hoboken). 2015;11:210-4. J Rheumatol. 2004;50:104-8. 2004;8:1-234. [ Links ], 55 Shleyfer E, Jotkowitz A, Karmon A, Nevzorov R, Cohen H, Buskila D. Accuracy of the diagnosis of fibromyalgia by family physicians: is the pendulum shifting. J Musculoskel Pain. 2009;31:116-22. Association of different levels of depressive symptoms with symptomatology, overall disease severity, and quality of life in women with fibromyalgia. 1995;15:77-80. [ Links ], 40 Vallejo MA, Rivera J, Esteve-Vives J. • Encaminhamento ao especialista deve ser reservado aos pacientes com sintomas atípicos ou desafios no manejo dos sintomas. B. Devem ser incluídas na presente Norma as pessoas com a situação clínica referenciada no n.º M79.7 Após definir os estudos potenciais para sustentação das recomendações, esses foram graduados pela força da evidência e grau de … OBJETIVO: A Fibromialgia (FM) apresenta sintomas expressivos de dor difusa e tender points em sistema músculo-esquelético. Pain. 2009;19:663-9. Assim, ainda não há exames complementares que a identifiquem, sendo estes usados apenas para diagnóstico diferencial (HEYMANN et al., 2010). It expresses a condition of instability at the level of vigilance and leads to brain fatigue in sleep preservation and regulation. The retrieved evidence was considered eligible if meeting the PICO method criteria. The 2010 ACR preliminary diagnostic criteria of FM are based on the number of tender areas of the body and on the presence and severity of fatigue, non-restorative sleep, cognitive difficulties, and the extent of somatic symptoms (D).12,13,19, Over time, it became evident that tender points have not been used or have been erroneously assessed by untrained physicians in clinical practice, particularly in primary care, causing failures in the final diagnosis. No significant differences were found between the groups after the stimuli.48, A study used stimulation with cold water and subsequent thermographic evaluation to examine potential differences between the autonomic nervous systems of patients with FM and healthy controls. Z Rheumatol. The tender point count may be correlated with the intensity of some symptoms, particularly emotional stress. [ Links ], 53 Roth T, Bhadra-Brown P, Pitman VW, Roehrs TA, Resnick EM. Biomed Thermol. Fibromialgia • Tratar o paciente com fibromialgia em nível de assistência primária à saúde. 1; IKEZAKI, F. I. A fibromialgia é um distúrbio crônico de dor centralizada, marcada por maciez muscular generalizada. em 1981, 11 que descreveram e caracterizaram o quadro clinico da FM. Subgrouping of fibromyalgia patients on the basis of pressure-pain thresholds and psychological factors. Junto com a dor, a fibromialgia cursa com sintomas de fadiga (cansaço), sono não reparador (a pessoa acorda cansada) e outros… Report of the Multicenter Criteria Committee. Searches were performed from August 2015 to September 2016 in the main primary databases of scientific information (Medline/PubMed, Embase, Lilacs/Scielo, Cochrane Library, Premedline via OVID), in addition to a manual search in the Brazilian Digital Library of Theses and Dissertations (Biblioteca Digital Brasileira de Teses e Dissertações - BDTD) of the Brazilian Institute for Information in Science and Technology (Instituto Brasileiro de Informação em Ciência e Tecnologia - IBICT; Table 1). Psychosom Med. Nel corso della diagnosi, il medico valuta anche la gravità dei sintomi correlati, come l' astenia, i disturbi del sonno ed i disturbi dell'umore. To minimize the subjectivity of clinical judgment, several diagnostic criteria were elaborated from 1980, though without unanimity, which generated more diagnostic confusion. These criteria were subsequently changed and are still under analysis by the rheumatologic medical community.13,14. [ Links ], 57 Goldenberg DL. [ Links ], 63 Jensen KB, Petzke F, Carville S, Fransson P, Marcus H, Williams SC, et al. [ Links ], 29 Häuser W, Hayo S, Biewer W, Gesmann M, Kühn-Becker H, Petzke F, et al. (Mood Disorders OR depression OR depressive) AND Fibromyalgia AND (sensitiv*[Title/Abstract] OR sensitivity and specificity[MeSH Terms] OR diagnos*[Title/Abstract] OR diagnosis[MeSH:noexp] OR diagnostic* [MeSH:noexp] OR diagnosis,differential[MeSH:noexp] OR diagnosis[Subheading:noexp]). After 6 months of follow-up, that difference may disappear. Las nuevas pautas no requieren un examen de los puntos sensibles. There is a cyclical and dysfunctional pattern of intensified pain and non-restorative sleep underlying the experience of fatigue in FM (B).38, In patients diagnosed with FM, in a one-year follow-up, sleep quality was permanently low when measured using the Pittsburgh Sleep Quality Index. Foram distribuídos 100 formulários, dos quais 56 foram preenchidos tendo sido todos contabilizados. La fibromialgia è ampiamente sotto-diagnosticata: si stima che siano necessari in media cinque anni affinché un paziente fibromialgico possa ottenere una diagnosi accurata. 100 es un máximo teórico excepcionalmente alcanzado. After defining the potential studies to support the recommendations, they were graded according to evidence and degree of recommendation. Semin Arthritis Rheum. [ Links ], 41 Stuifbergen AK, Phillips L, Carter P, Morrison J, Todd A. Subjective and objective sleep difficulties in women with fibromyalgia syndrome. Las respuestas que usted proporcionará a este cuestionario permitirán conocer mejor el impacto de su enfermedad sobre su calidad de vida día a día. [ Links ], 5 Bannwarth B, Blotman F, Roué-Le Lay K, Caubère JP, André E, Taïeb C. Fibromyalgia syndrome in the general population of France: a prevalence study. No significant differences were identified between the groups.49, A study involving 23 women with FM and 15 healthy controls observed that patients with FM showed lower tolerance to cold water than participants in the control group. Should tender points be considered in the diagnosis of FM? Thermol Int. A fibromialgia é uma doença reumatológica com prevalência de 2,5% na população brasileira, sendo maioria do sexo feminino entre 35 e 44 anos (1). 2 Resumo Introdução: Fibromialgia significa dores nos músculos e tecidos conectivos fibrosos. (tender point* OR pressure OR pain threshold) AND Fibromyalgia AND (sensitiv*[Title/Abstract] OR sensitivity and specificity[MeSH Terms] OR diagnos*[Title/Abstract] OR diagnosis[MeSH:noexp] OR diagnostic* [MeSH:noexp] OR diagnosis,differential[MeSH:noexp] OR diagnosis[Subheading:noexp]). Chronic widespread pain and fibromyalgia: what we know, and what we need to know. Those patients also have higher associations with other symptoms, such as fatigue and reduced function and energy (B).41. The need for involving a multidisciplinary team in FM is another obstacle related to the capacity to measure tender points. 2015;24:2951-7. Health Qual Life Outcomes. 2015;21:86-99. Are the 1990 ACR criteria essential for the diagnosis of fibromyalgia (FM)? Conversely, the 2010 ACR criteria modified in 2011 are more suitable for research because they are easily administered (self-administered) and, therefore, reach a higher number of patients.42, The ease of use of the 2010 ACR criteria indicates their application mainly to primary care because the diagnosis covers the main patient complaints and assesses the severity of the clinical symptoms and the patient follow-up.20. [ Links ], 37 Walker EA, Keegan D, Gardner G, Sullivan M, Katon WJ, Bernstein D. Psychosocial factors in fibromyalgia compared with rheumatoid arthritis: I. Existen unos criterios diagnósticos de fibromialgia elaborados por el Colegio Americano de Reumatología en el año 1990 (Criterios ARC 1990) para el diagnóstico de la fibromialgia: Dolor musculoesquelético generalizado y continuo , de más de tres meses de evolución, afectando al menos tres de los cuatro cuadrantes corporales. 1 A influência de aspectos sociais, psicológicos e culturais torna sua expressão clínica altamente variável. When assessed by a family physician, agreement with the diagnosis of the rheumatologist was 87% (B).55, The 1990 ACR Diagnostic Criteria showed high sensitivity and specificity when widespread chronic pain and tender point counts were present. [ Links ], 10 Hench PK. Are the 1990 ACR criteria essential for the diagnosis of FM? A fibromialgia é uma doença crónica, de etiologia pouco clarificada, diagnóstico incerto, fenótipo muito variável e tratamento muito heterogéneo. In summary, the studies revealed no pattern of thermographic changes in FM syndrome. Anxiety and depressive symptoms in fibromyalgia are related to poor perception of health but not to pain sensitivity or cerebral processing of pain. 2005;32:348-53. In studies performed in the USA and in Europe, the prevalence found was up to 5% in the general population,1-5 surpassing 10% of visits in rheumatology clinics.6 In Brazil, FM is present in up to 2.5% of the general population, predominantly among women, especially from 35 to 44 years of age.7,8. 1.1. ), with searches in the main, primary databases of scientific information. Arthritis Rheum. Using a dolorimeter, with a 4.0 kg/cm2 cut-off point for pain threshold, each tender point will provide good sensitivity and specificity significant for the diagnosis of FM. um ambulatório de fibromialgia de um hospital universitário. How? Revista Brasileira de Medicina 2010 11(2):35-42. The use of the Widespread Pain Index (WPI >7) combined with the Symptom Severity Scale (SS >5), both based on patient symptoms (pain, fatigue, sleep, cognition, and somatic symptoms), enabled a 90.8% diagnostic accuracy (90.9% sensitivity and 85.9% specificity) when compared with the 1990 ACR criteria (B).13, At 49% pre-test probability, combining the positivity of the 1990 and 2010 ACR criteria enabled diagnostic certainty in 99% cases (B).13,21.
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