Background/Purpose: Both the revised 2010 FM criteria (Wolfe et al.) and the 2013 FM criteria (Bennett et al.), rely on counting the number of pain locations plus a certain number of symptoms as presumptive evidence for the patient having widespread pain. However, little is known about how these criteria operate in the primary setting.

Methods: A descriptive cross sectional study assessed adults being seen in2 primary care clinics. Data sources included chart review, history, physical exam and patient-completed surveys.

Results: Altogether 357 patients were studied (all female, age 50 ± 16.3 years). Chart review revealed that 50 patients carried a diagnosis of FM in their medical record. However, only 17 patients fulfilled the 2013 FM diagnostic criteria. A comparison of the 2 diagnostic groups is shown in the following table:

Conclusion: These results show that clinician diagnosed and criteria diagnosed patients were very similar in most descriptive variables. The 2013 criteria are based on a pain locations score >16 and a SIQR symptom score of>21. It is seen that the symptoms score does not account for the difference in diagnosis, but the number of pain locations was significantly less in the clinician diagnosed FM. Thus it appears that there is a group of “fibromyalgia like” patients that differ from 2013 criteria patients only in the number of pain locations. This raises 3 questions: 1. What should we call the clinic diagnosed patients who are symptomatically similar but differ from criteria diagnosed patients only in the number of pain locations? 2. Is the number of pain locations representative of the concept of widespread pain? 3. Would the concept of widespread pain be better defined by a question, such as seen in the last row?

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/can-fibromyalgia-be-empirically-defined-by-the-number-of-pain-locations-plus-symptoms/