{"id":65,"date":"2009-02-27T00:07:53","date_gmt":"2009-02-27T00:07:53","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/reufibromyalgia\/"},"modified":"2025-05-14T21:00:11","modified_gmt":"2025-05-14T21:00:11","slug":"reufibromyalgia","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/reufibromyalgia\/","title":{"rendered":"1990 Criteria of ACR for the Classification of Fibromyalgia"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Fibromyalgia syndrome (FMS) is conceptualized as a chronic disorder characterized by widespread and persistent non-inflammatory musculoskeletal pain. Concomitant symptoms usually include fatigue, insomnia, morning stiffness, depression, anxiety, and cognitive problems (forgetfulness, concentration difficulties, mental slowness, memory and attention problems, etc.). Furthermore, the majority of FMS patients usually show predominantly negative affect, including neuroticism, alexithymia, and catastrophizing and impaired health-related quality of life.<!--more--><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\">1. History of widespread pain. <\/span><\/p>\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Definition.<\/span><\/em><span style=\"color: black;\"> Pain is considered widespread when all of the following are present: pain in the left side of the body, pain in the right side of the body, pain above the waist, and pain below the waist. In addition, axial skeletal pain (cervical spine or anterior chest or thoracic spine or low back) must be present. In this definition, shoulder and buttock pain is considered as pain for each involved side. &#8220;Low back&#8221; pain is considered lower segment pain. <\/span><\/p>\n<\/li>\n<\/ul>\n<p>2. Pain in 11 of 18 tender point sites on digital palpation.<\/p>\n<div class=\"Section1\">\n<ul>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Definition.<\/span><\/em><span style=\"color: black;\"> Pain, on digital palpation, must be present in at least 11 of the following 18 sites: <\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Occiput:<\/span><\/em><span style=\"color: black;\"> Bilateral, at the suboccipital muscle insertions. <\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Low cervical:<\/span><\/em><span style=\"color: black;\"> bilateral, at the anterior aspects of the intertransverse spaces at C5-C7.<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Trapezius:<\/span><\/em><span style=\"color: black;\"> bilateral, at the midpoint of the upper border. <\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Supraspinatus:<\/span><\/em><span style=\"color: black;\"> bilateral, at origins, above the scapula spine near the medial border.<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Second rib:<\/span><\/em><span style=\"color: black;\"> bilateral, at he second costochondral junctions, just lateral to the junctions on upper surfaces.<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Lateral epicondyle:<\/span><\/em><span style=\"color: black;\"> bilateral, 2 cm distal to the epicondyles. <\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Gluteal:<\/span><\/em><span style=\"color: black;\"> bilateral, in upper outer quadrants of buttocks in anterior fold of muscle.<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Greater trochanter:<\/span><\/em><span style=\"color: black;\"> bilateral, posterior to the trochanteric prominence.<\/span><\/p>\n<\/li>\n<li>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><em> <span style=\"color: black;\"> Knee:<\/span><\/em><span style=\"color: black;\"> bilateral, at the medial fat pad proximal to the joint line.<\/span><\/p>\n<\/li>\n<\/ul>\n<\/div>\n<div class=\"Section1\"><\/div>\n<div class=\"Section1\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> Digital palpation should be performed with an approximate force of 4 kg.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><span style=\"color: black;\"> For a tender point to be considered &#8220;positive&#8221; the subject must state that the palpation was painful. &#8220;Tender is not to be considered &#8220;painful.&#8221; <\/span><\/p>\n<p class=\"MsoNormal\">* For classification purposes, patients will be said to have fibromyalgia if both criteria are satisfied. Widespread pain must have been present for at least 3 months. The presence of a second clinical disorder does not exclude the diagnosis of fibromyalgia.<\/p>\n<p>&nbsp;<\/p>\n<\/div>\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<ol>\n<li>Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990 Feb;33(2):160-72.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/2306288\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Oct 24, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[45],"tags":[1522,423,166,167,16,15,466,467,1070],"class_list":["post-65","post","type-post","status-publish","format-standard","hentry","category-rheumatology","tag-1522","tag-acr","tag-clasificacion","tag-classification","tag-criteria","tag-criterios","tag-fibromialgia","tag-fibromyalgia","tag-rheumatology"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/65","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=65"}],"version-history":[{"count":5,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/65\/revisions"}],"predecessor-version":[{"id":9379,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/65\/revisions\/9379"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=65"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=65"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=65"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}