Session Title: Fibromyalgia and Soft Tissue Disorders
Session Type: Abstract Submissions (ACR)
To compare the fibromyalgia patients who meet the 1990 ACR criteria for fibromyalgia with those who do not.
All new consecutive patients diagnosed with fibromyalgia that were seen in the Rheumatology Department at the Cleveland Clinic by two physicians between September 1st, 2008 and January 31st, 2011, were enrolled in the study.
Enrollment in the study was based on clinician’s overall impression of patient suffering from fibromyalgia.
Three hundred and six patients were enrolled.
Data collected included: demographics, detailed fibromyalgia symptoms, physical examination findings (tender points, brisk deep-tendon reflexes and carotid artery tenderness on palpation), family history of fibromyalgia and mood disorders and comorbidities. All patients were asked to complete the following questionnaires: Brief Patient Health Questionnaire Mood Scale (PHQ -9), Epworth Sleepiness Scale (ESS), Mood Disorders Questionnaire (MDQ), Fibromyalgia impact questionnaire (FIQ), Symptom Intensity Scale (SIS) and Health Assessment Questionnaire Disability Index (HAQ-DI ).
We compared 240 fibromyalgia patients who met the ACR 1990 criteria with the other 66 patients who did not (lacked widespread pain or had <11 tender points). Patients who met the ACR 1990 criteria, compared to the rest of the patients, had higher depression scores, PHQ-9 12 (7.75, 16) vs 9.5 (5, 14.7), p<0.03; higher regional pain scores 12 (9, 15) vs 9 (6, 12), p<0.001; higher VAS fatigue 8 (7, 9) vs 7.25 (5, 9), p =0.022; higher symptom intensity score SIS 7 ( 6.21, 8.25) vs 6.25 (5.25, 6. 75), p <0.001; higher FIQ score 69.03 (65.1, 80.8) vs 59.95 (46.11, 72.74), p =0.001; higher difficulty with daily activities involving large muscle groups - FIQ-1 score 16 (7, 24) vs 12 (7, 20), p 0.039; less days when they felt well in the course of a week - FIQ-2 score 1(0, 2) vs 2 ( 0, 3) , p = 0.003.
Fibromyalgia patients who meet the ACR 1990 criteria represent a more severe subset, manifested by more disability, and higher depression scores.
C. E. Gota,
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