Session Information
Title: Fibromyalgia, Soft Tissue Disorders, Regional and Specific Clinical Pain Syndromes: Research Focus
Session Type: Abstract Submissions (ACR)
Background/Purpose:
It has been suggested that patients with fibromyalgia very often have radiographic straight neck. According to one study, 71% of patients with fibromyalgia lose the normal radiographic cervical lordosis. In this report, straight neck was defined as a Cobb angle < 14 degrees. (Katz & Farkasch. Abstract 1086, 2013 ACR Annual Meeting)
Objective: Our objective was to further investigate this potentially important clinical association. We set to define the prevalence of radiographic cervical spine straight neck in patients with fibromyalgia as compared with patients suffering from other musculoskeletal diseases.
Methods: Adult patients attending an outpatient rheumatology clinic of a military hospital were invited to participate in the study. A lateral cervical radiograph in neutral position was obtained in all instances. Cobb angle was used to label the radiographs as “normal” (Cobb angle > 18 degrees) “borderline” (Cobb angle between 14 and 18) and “straight neck” (Cobb angle < 14). A rheumatologist blinded to the radiograph results prospectively examined each patient from the “normal” and “straight neck” groups. The 1990 and 2010 ACR criteria were used to define the presence of fibromyalgia.
Results ; are summarized in the table. A total of 56 patients were studied. Only 14 of them had “normal” radiographic cervical lordosis. Of the total group, 35.7% fulfilled either the 1990 or the 2010 ACR fibromyalgia diagnostic criteria. Fibromyalgia was more frequent in the “normal” radiograph group (64%) than in the “straight neck” group (26%) (p = 0.022 )
Conclusion: Fibromyalgia is very frequent in this military rheumatology clinic. Contrary to our working hypothesis, our results show that patients with fibromyalgia have less radiographic straight neck when compared to patients with other rheumatic diseases.
|
Total n=56 |
“Primary” fibromyalgia n=14 |
Fibromyalgia + other rheumatic illness n=6 |
Other rheumatic disease without fibromyalgia n=17 |
Neither autoimmune disease nor fibromyalgia n=19 |
p |
|
Age (years) |
49.3 ± 8.9 |
42.8 ± 6.6 |
38.1 ± 10.8 |
35.8 ± 12.6 |
0.006 |
|
Women (%) |
13 (92.9%) |
6 (100%) |
11 (64.7%) |
14 (73.7%) |
0.136 |
|
Cobb’s angle (radial degrees) |
14.9 ± 8.7 |
14.7 ± 7.1 |
11.1 ± 5.4 |
8.6 ± 6.4 |
0.054 |
|
Straight neck <14° (%) |
7 (50%) |
4 (66.7%) |
14 (82.4%) |
17 (89.5%) |
0.058 |
|
Number of tender points |
14.0 ± 2.5 |
14.3 ± 2.3 |
4.7 ± 4.9 |
2.5 ± 3.5 |
<0.0001 |
|
FM according 1990 ACR criteria (%) |
11 (78.6%) |
5 (83.3%) |
3 (17.6%) |
1 (5.3%) |
<0.0001 |
|
Widespread pain index |
12.7 ± 3.1 |
14.8 ± 4.4 |
4.1 ± 3.6 |
2.2 ± 2.1 |
<0.0001 |
|
Symptom severity score |
7.5 ± 2.2 |
8.3 ± 1.6 |
3.4 ± 1.7 |
2.5 ± 1.5 |
<0.0001 |
|
FM according 2010 ACR criteria (%) |
14 (100%) |
6 (100%) |
0 (0%) |
0 (0%) |
<0.0001 |
Disclosure:
O. E. Muñoz-Monroy,
None;
L. A. Martinez-Martinez,
None;
M. Martínez-Lavín,
None;
B. A. Mota-Mondragón,
None;
E. Martínez-Hernández,
None.
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