Aquí dejo los criterios actuales de fibromialgia (FM), en adultos (2010) y los usados para diagnosticar FM juvenil.
Juvenile Criteria
Yunus & Masi Criteria for Childhood Fibromyalgia (Yunus and Masi 1985)
All 4 major and 3 minor, OR the first 3 major, 4 painful sites, and 5 minor need to satisfied
Major:
1. Generalized musculoskeletal aching at 3 or more sites for 3 or more months
2. Absence of underlying condition or cause
Minor:
Yunus & Masi Criteria for Childhood Fibromyalgia (Yunus and Masi 1985)
All 4 major and 3 minor, OR the first 3 major, 4 painful sites, and 5 minor need to satisfied
Major:
1. Generalized musculoskeletal aching at 3 or more sites for 3 or more months
2. Absence of underlying condition or cause
3. Normal laboratory tests
4. 5 or more typical tender points (see sites under 1990 ACR criteria above)
Minor:
1. Chronic anxiety or tension
2. Fatigue
3. Poor Sleep
4. Chronic headaches
5. Irritable bowel syndrome
6. Subjective soft tissue swelling
7. Numbness
8. Pain modulation by physical activities
9. Pain modulation by weather factors
10. Pain modulation by anxiety or stress
Referencias
Merskey, H.
and N. Bogduk (1994). Classification of chronic pain:
descriptions of chronic pain syndromes and definitions of pain terms. Second
Edition. Seattle, IASP press.
Wolfe, F., et al. (1990). “The
American College of Rheumatology 1990 Criteria for the Classification of
Fibromyalgia. Report of the Multicenter Criteria Committee.” Arthritis
& Rheumatism 33(2): 160-172.
Yunus, M. B. and A. T. Masi (1985).
“Juvenile primary fibromyalgia syndrome. A clinical study of thirty-three
patients and matched normal controls.” Arthritis & Rheumatism 28(2): 138-145.
2010 American
College of Rheumatology criteria for fibromyalgia
All 3 conditions must be satisfied:
- Absence of a disorder to explain the pain
- Symptoms present for 3 months
- One of the below
- a. Widespread pain index ≥ 7 and symptom severity score≥ 5
- b. Widespread pain index 3-6 and symptom severity score≥ 9
-----Widespread
pain equals the number of areas of pain in the last week (0-19 points)
areas include: shoulder girdle,
upper arm, lower arm, buttocks/trochanter, upper leg, lower leg, jaw, upper
back, lower back ( 1 point if unilateral; 2 points if bilateral) and 1 point
each for chest, abdomen, neck
-----Symptom
severity score (0-12)
the following 3 symptoms are scored
0 to 3 each (0 = no problem, 1 = mild or intermittent, 2 equals moderate or considerable,
3 = severe, continuous)
1. Fatigue
2. Waking unrefreshed
3. Cognitive symptoms
4. Plus a somatic symptom score of 0-3 (0 = no symptoms, 1 = few
symptoms, 2 = moderate number of symptoms, 3 = great deal of symptoms)
The
symptoms that can be considered include: muscle pain, irritable bowel syndrome,
tiredness, thinking problems, muscle weakness, headache, abdominal pain,
numbness and tingling, dizziness, insomnia, depression, constipation, upper
abdominal pain, nausea, nervousness, chest pain, blurred vision, fever,
diarrhea, dry mouth, itching, wheezing, Raynaud phenomenon, hives, tenderness,
vomiting, heartburn, oral ulcers, change in taste, seizures, dry eyes,
shortness of breath, loss of appetite, rash, sensitivity, hearing difficulties,
easy bruising, hair loss, urinary frequency, dysuria, bladder spasms.
Referencias:
Wolf F, Clauw DJ, Fitzcharles MA, et al The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research Vol. 62, No. 5, May 2010, pp 600–610 DOI 10.1002/acr.20140
Wolf F, Clauw DJ, Fitzcharles MA, et al The American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia and Measurement of Symptom Severity. Arthritis Care & Research Vol. 62, No. 5, May 2010, pp 600–610 DOI 10.1002/acr.20140
Creado por Laura Ricaurte Gracia - Anestesióloga -Especialista en Dolor y Cuidados Paliativos
