Which of the three different tender points assessment methods is more useful for predicting the severity of Fibromyalgia syndrome?

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Journal: Rheumatology International. 2006 Oct 7 [E-publication ahead of print]

PMID: 17028859

Authors and affiliation: Tastekine N, Birtane M, Uzunca K. Physical Medicine and Rehabilitation Department, Medical Faculty, Trakya University, Edirne, Turkey.

Digital palpation, myalgic scoring, and dolorimetry are frequently used to count tender points in Fibromyalgia syndrome. [Digital palpation determines if pressure of about 4 kg elicits pain; myalgic scoring involves a rating of each point on a scale of zero to 3 (maximum worst myalgic score is 54, or 3 times 18; the dolorimeter (palpometer) is an instrument the examiner employs that records the pressure exerted at the time pain is felt.]

We aimed to investigate the probable relation between tender points count and Fibromyalgia Impact Questionnaire, and to assess which of the tender point counting methods is the most successful in predicting the severity of the disease.

Tender point areas of 36 patients with Fibromyalgia syndrome were assessed with three methods, which are myalgic scoring and digital and dolorimetric tender points counting methods. Fibromyalgia Impact Questionnaire was used to measure the disease severity. The correlation between each of the assessment methods and Fibromyalgia Impact Questionnaire was investigated.

The mean count of digitally evaluated tender points was 14.86 +/- 2.67 and by dolorimetry was 11.81 +/- 4.48. The mean total myalgic score was found to be 24.61 +/- 8.91.

All of the tender point evaluation methods correlated positively with each other (P < 0.01). Fibromyalgia Impact Questionnaire score was also correlated with only digital palpation tender point count of these three evaluation methods (r = 0.427, P < 0.05).

Digital tender point count seemed to be sufficient for assessment, and there is no need for an additional instrument for tender point evaluation.

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