A standardized manual tender point survey. I. Development & determination of a threshold point for the ident. of positive tender points in fibromyalgia syndrome (FMS)

OBJECTIVE: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

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