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ACR Criteria for the Classification of Fibromyalgia

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The American College of Rheumatology 1990

Criteria for the Classification of Fibromyalgia

History of widespread pain has been present for at least three months
Definition: Pain is considered widespread when all of the following are present:

Pain in both sides of the body

Pain above and below the waist

In addition, axial skeletal pain (cervical spine, anterior chest, thoracic spine or low back pain) must be present. Low back pain is considered lower segment pain.

Pain in 11 of 18 tender point sites on digital palpation
Definition: Pain, on digital palpation, must be present in at least 11 of the following 18 tender point sites:

Occiput (2) – at the suboccipital muscle insertions.

Low cervical (2) – at the anterior aspects of the intertransverse spaces at C5-C7.

Trapezius (2) – at the midpoint of the upper border.

Supraspinatus (2) – at origins, above the scapula spine near the medial border.

Second rib (2) – upper lateral to the second costochondral junction.
Lateral epicondyle (2) – 2 cm distal to the epicondyles.

Gluteal (2) – in upper outer quadrants of buttocks in anterior fold of muscle.

Greater trochanter (2) – posterior to the trochanteric prominence.

Knee (2) – at the medial fat pad proximal to the joint line.

Digital palpation should be performed with an approximate force of 4 kg. A tender point has to be painful at palpation, not just “tender.”

Fibromyalgia Syndrome Symptoms

Arthritis and Rheumatism, Vol. 33, No. 2, Feb 1990, F. Wolfe, et al.

Condition % of FMS Symptoms

Muscular Pain 100

Fatigue 96

Insomnia 86

Joint Pains 72

Headaches 60

Restless Legs 56

Numbness and Tingling 52

Impaired Memory 46

Leg Cramps 42

Impaired Concentration 41

Nervousness 32

Depression (Major Depression) 20

Source of this info: National Fibromyalgia Research Association
PO Box 500, Salem, OR 97308

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