Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Hospital, Seoul, Korea.
Korean J Pain. 2012 Jul;25(3):173-82. doi: 10.3344/kjp.2012.25.3.173. Epub 2012 Jun 28.
Fibromyalgia (FM) is characterized by chronic widespread pain with a low pain threshold. The aim of this study was to compare two criteria for the diagnosis and assessment of FM and to analyze the correlation and agreement between the 1990 and 2010 American College of Rheumatology (ACR) preliminary diagnostic criteria for FM.
We studied 98 patients who had already been diagnosed as having FM using the 1990 criteria or 2010 preliminary criteria. Tender point examination, FM impact questionnaire (FIQ) and pain visual analog scale (VAS) were obtained. According to the preliminary criteria, FM was quantified as WPI (widespread pain index) and the SS scale (symptom severity) and the two criteria were compared.
Among 98 patients, 78.6% of the patients were diagnosed with the 1990 ACR criteria and 93.9% of the patients were diagnosed with the ACR preliminary diagnostic criteria, and there was also significant agreement between the two criteria (P < 0.01). There was a correlation with the WPI and the tender point, with the SS and the FIQ, and with the sum of the WPI and SS and the FIQ.
The ACR preliminary diagnostic criteria for FM were in agreement with the 1990 ACR criteria during the disease course. The preliminary criteria were the more sensitive method than the 1990 criteria. In addition, the 2010 criteria might have advantages since it is easy to assess the physical and psychological symptoms and can be quantified. Therefore, the ACR preliminary diagnostic criteria for FM could be used more conveniently for clinical diagnosis and follow up evaluation after starting management of FM.
纤维肌痛(FM)的特征是慢性广泛性疼痛伴低痛阈。本研究旨在比较两种 FM 诊断和评估标准,并分析 1990 年和 2010 年美国风湿病学会(ACR)纤维肌痛初步诊断标准之间的相关性和一致性。
我们研究了 98 例已根据 1990 年标准或 2010 年初步标准诊断为 FM 的患者。进行了压痛检查、纤维肌痛影响问卷(FIQ)和疼痛视觉模拟量表(VAS)。根据初步标准,FM 量化为 WPI(广泛疼痛指数)和 SS 量表(症状严重程度),并比较了这两个标准。
在 98 例患者中,78.6%的患者根据 1990 年 ACR 标准诊断为 FM,93.9%的患者根据 ACR 初步诊断标准诊断为 FM,两种标准之间也有显著一致性(P<0.01)。WPI 与压痛点、SS 与 FIQ、WPI 与 SS 之和与 FIQ 之间存在相关性。
在疾病过程中,ACR 纤维肌痛初步诊断标准与 1990 年 ACR 标准一致。初步标准比 1990 年标准更敏感。此外,2010 年标准可能具有优势,因为它易于评估身体和心理症状并进行量化。因此,ACR 纤维肌痛初步诊断标准可更方便地用于纤维肌痛的临床诊断和治疗管理后随访评估。