Kumbhare Dinesh, Ahmed Sara, Watter Scott
Division of Physical Medicine and Rehabilitation, Department of Medicine, Toronto Rehabilitation Institute, 550 University Avenue, Toronto, ONT, Canada M5G 2A2.
Faculty of Science, McMaster University, Hamilton, ON, Canada.
Ther Adv Musculoskelet Dis. 2018 Jan;10(1):13-26. doi: 10.1177/1759720X17740076. Epub 2017 Dec 7.
Fibromyalgia presents a clinical enigma as its pathophysiology is not well understood and its symptoms are nonspecific and overlap with many disorders, making its diagnosis a challenge for clinicians and researchers. Efforts have been made to develop a set of diagnostic criteria for this disorder. However, these criteria rely heavily on expert clinician opinion and produce a large heterogeneity within the diagnosed population. With no present specific technique reflecting the underlying pathophysiology of fibromyalgia, a definitive diagnosis of fibromyalgia remains elusive. This review discusses some problems and challenges associated with fibromyalgia diagnosis and presents some novel findings on the pathophysiological nature of fibromyalgia.
纤维肌痛是一个临床难题,因为其病理生理学尚未被充分理解,症状不具特异性且与许多疾病重叠,这使得临床医生和研究人员难以对其进行诊断。人们已努力为这种疾病制定一套诊断标准。然而,这些标准严重依赖临床专家的意见,且在已确诊人群中产生了很大的异质性。由于目前没有反映纤维肌痛潜在病理生理学的特定技术,纤维肌痛的明确诊断仍然难以实现。本文综述讨论了与纤维肌痛诊断相关的一些问题和挑战,并介绍了有关纤维肌痛病理生理学本质的一些新发现。