Fibromyalgia with chronic rheumatic diseases in South Korea: a comparison of clinical and American College of Rheumatology criteria

Int J Rheum Dis. 2017 Dec;20(12):1922-1926. doi: 10.1111/1756-185X.12678. Epub 2015 May 20.

Abstract

Aim: To describe the prevalence and characteristics of fibromyalgia (FM) in patients with underlying rheumatic disease, and to compare it by three different measures.

Methods: We studied 546 patients with chronic rheumatic diseases who attended our rheumatology clinic. If patients answered all of a screening questionnaire with yes, then we considered patients to be having widespread pain as assessed by the fibromyalgia impact questionnaire (FIQ), widespread pain index (WPI), and symptom severity (SS). A physician administered the tender point (TP) exam and clinician's judgment of FM. We collected demographics, clinical and laboratory features.

Results: One hundred and sixty-four (30.0%) patients among 546 cases had a further exam. The male-to-female count was 25 : 139. The mean age was 49.7 years, disease duration 3.7 years, TP counts 4.2, FIQ score 47.0 and WPI with SS score was 11.1. We classified 17 patients (10.4%) with concomitant FM with widespread pain by tender point exam, 56 patients (34.2%) by WPI with SS, and 36 patients (22.0%) by a clinician's judgment. A total of 70.6% (n = 12) of those classified as FM by 1990 American College of Rheumatology (ACR) criteria wee categorized as FM by clinician's judgment, while 33.3% by clinician's judgment were classified by 1990 ACR criteria.

Conclusions: We found a 10.4~34.2% prevalence of concomitant FM in the patients with chronic widespread pain. The 1990 ACR criteria were the most restrictive except for SLE. Although The 2010 ACR criteria had a wide spectrum, it can be used for FM diagnosis even in the patient with underlying rheumatic diseases.

Keywords: South Korea; clinician's or American College of Rheumatology criteria; concomitant rheumatic disease; fibromyalgia.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Chronic Pain / diagnosis*
  • Chronic Pain / epidemiology*
  • Chronic Pain / physiopathology
  • Female
  • Fibromyalgia / diagnosis*
  • Fibromyalgia / epidemiology*
  • Fibromyalgia / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement*
  • Pain Threshold
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Republic of Korea / epidemiology
  • Rheumatic Diseases / diagnosis*
  • Rheumatic Diseases / epidemiology*
  • Rheumatic Diseases / physiopathology
  • Severity of Illness Index
  • Surveys and Questionnaires*