Okifuji A, Turk D C, Sinclair J D, Starz T W, Marcus D A
Department of Anesthesiology, University of Washington, Seattle 98195, USA.
J Rheumatol. 1997 Feb;24(2):377-83.
To (a) develop a standardized tender point examination protocol [Manual Tender Point Survey (MTPS)] as a diagnostic procedure to evaluate the tender point (TP) criterion for fibromyalgia syndrome (FM) and (b) determine a threshold point for positive TP.
A standardized MTPS consisted of standardized components including (a) location of the survey sites, (b) patient and examiner positioning, (c) order of examination, (d) pressure application technique, and (e) pain severity rating scores [0 (no pain) - 10 (worst pain)]. Seventy patients with FM and 70 with chronic headache were examined using the MTPS protocol.
A pain severity score of 2 (i.e., 0-1 = negative) was found to be an optimal threshold point for identifying positive TP, with sensitivity of 88.57% and specificity of 71.43%. These results are comparable to the sensitivity and specificity of the 1990 multicenter study.
The MTPS provides a step-by-step, standardized TP examination protocol, which is sensitive and specific in discriminating patients with FM from patients with chronic headache.
(a) 制定一种标准化的压痛点检查方案 [手动压痛点调查 (MTPS)]，作为评估纤维肌痛综合征 (FM) 压痛点 (TP) 标准的诊断程序；(b) 确定阳性 TP 的阈值点。
标准化的 MTPS 由标准化组件组成，包括 (a) 调查部位的位置，(b) 患者和检查者的体位，(c) 检查顺序，(d) 施压技术，以及 (e) 疼痛严重程度评分 [0（无疼痛）- 10（最严重疼痛）]。使用 MTPS 方案对 70 例 FM 患者和 70 例慢性头痛患者进行检查。
发现疼痛严重程度评分为 2（即 0 - 1 = 阴性）是识别阳性 TP 的最佳阈值点，敏感性为 88.57%，特异性为 71.43%。这些结果与 1990 年多中心研究的敏感性和特异性相当。
MTPS 提供了一种逐步的、标准化的 TP 检查方案，在区分 FM 患者和慢性头痛患者方面具有敏感性和特异性。
