The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee.

Authors: Wolfe F (1) , Smythe HA (2) , Yunus MB (3) , Bennett RM (4) , Bombardier C (2) , Goldenberg DL (5) , Tugwell P (6) , Campbell SM (4) , Abeles M (7) , Clark P (6) , Fam AG (8) , Farber SJ (9) , Fiechtner JJ (10) , Franklin CM (11) , Gatter RA (11) , Hamaty D (12) , Lessard J (13) , Lichtbroun AS (14) , Masi AT (3) , McCain GA (15) , Reynolds WT (16) , Romano TJ (17) , Russell IJ (18) , Sheon RP (9)
(1) University of Kansas (2) The Wellesley Hospital (3) University of Illinois (4) Oregon Health Sciences University (5) Boston University School of Medicine (6) McMaster University (7) University of Connecticut (8) Sunnybrook Medical Centre (9) Toledo Clinic (10) University of North Dakota (11) Center for Arthritis and Back Pain, Willow Grove (12) City of Faith, Tulsa (13) Grand Forks Clinic (14) Metuchen (15) University Hospital, London, Ontario (16) Toronto Western Hospital (17) Wheeling Hospital (18) University of Texas Health Science Center
Source: Arthritis Rheum. 1990 Feb;33(2):160-72.
DOI: 10.1002/art.1780330203 Publication date: 1990 Feb E-Publication date: Dec. 9, 2005 Availability: abstract Copyright: © 1990 American College of Rheumatology
Language: English Countries: Not specified Location: Not specified Correspondence address: Frederick Wolfe : The Arthritis Center, 1035 North Emporia, Wichita, KS 67214


Article abstract

To develop criteria for the classification of fibromyalgia, we studied 558 consecutive patients: 293 patients with fibromyalgia and 265 control patients. Interviews and examinations were performed by trained, blinded assessors. Control patients for the group with primary fibromyalgia were matched for age and sex, and limited to patients with disorders that could be confused with primary fibromyalgia. Control patients for the group with secondary-concomitant fibromyalgia were matched for age, sex, and concomitant rheumatic disorders. Widespread pain (axial plus upper and lower segment plus left- and right-sided pain) was found in 97.6% of all patients with fibromyalgia and in 69.1% of all control patients. The combination of widespread pain and mild or greater tenderness in greater than or equal to 11 of 18 tender point sites yielded a sensitivity of 88.4% and a specificity of 81.1%. Primary fibromyalgia patients and secondary-concomitant fibromyalgia patients did not differ statistically in any major study variable, and the criteria performed equally well in patients with and those without concomitant rheumatic conditions. The newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites. No exclusions are made for the presence of concomitant radiographic or laboratory abnormalities. At the diagnostic or classification level, the distinction between primary fibromyalgia and secondary-concomitant fibromyalgia (as defined in the text) is abandoned.

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