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Are tender point scores assessed by manual palpation in fibromyalgia (FM) reliable?

To determine the reliability of tender point assessment by manual
palpation in patients with fibromyalgia, and to investigate
the sources of variance, tender point scores by manual
palpation were obtained in 30 fibromyalgia patients by 2
investigators; the assessments were repeated after 1 week.
Test-retest stability and inter-observer agreement of tender
point scores was moderate to high. The most important sources
of variance were inter-individual patient differences in (1)
mean tenderness (pain thresholds) and (2) tender point
profiles (consistent intra-individual differences between the
14 tender point scores), and (3) residual variance, not
attributable to any systematic effect (error). It is concluded
that the reliability of tender point assessment by manual
palpation is acceptable. It seems to be not less than
reliability of assessment by pressure algometer. Tender point
scores in fibromyalgia reflect individual differences in mean
pain thresholds as well as individual tender point profiles.

Jacobs JW, Geenen R, van der Heide A, Rasker JJ, Bijlsma JW