Fibromyalgia (cont.)
How is fibromyalgia diagnosed?
There are no blood tests or X-ray tests that help the doctor determine whether someone has fibromyalgia. These tests are done to exclude other possible diagnoses. Therefore, the diagnosis of fibromyalgia is made purely on clinical grounds based on the doctor's history and physical examination. In patients with widespread body pain, the diagnosis of fibromyalgia can be made by identifying point tenderness areas (typically, patients will have at least 11 of the 18 classic tender points), by finding no accompanying tissue swelling or inflammation, and by excluding other medical conditions that can mimic fibromyalgia. Many medical conditions can cause pain in different areas of the body, mimicking fibromyalgia. These conditions include
Again, even though there is no blood test for fibromyalgia, blood
tests are
important to exclude other medical conditions. Therefore,
thyroid hormone
and calcium blood levels are obtained to exclude hypercalcemia,
hyperparathyroidism, and
hypothyroidism. The blood alkaline
phosphatase (a bone enzyme) level is often raised in patients with Paget's
disease of the bone. The CPK (a muscle enzyme) level is often elevated in
patients with polymyositis, a disease with diffuse muscle inflammation.
Therefore, obtaining alkaline phosphatase and CPK blood levels can help the
doctor decide whether Paget's disease and polymyositis are the causes
of bone and
muscle pains. A complete blood count (CBC) and liver tests
help in the
diagnosis of hepatitis and other infections.
Fibromyalgia can
occur alone or in association with other systemic rheumatic conditions.
Systemic rheumatic conditions refer to diseases that can cause inflammation and
damage to numerous different tissues and organs in the body. Systemic rheumatic
conditions associated with fibromyalgia include systemic lupus erythematosus, rheumatoid
arthritis, polymyositis, and
polymyalgia rheumatica. Blood tests which are helpful in evaluating these diseases
include erythrocyte sedimentation rate
(ESR), serum protein electrophoresis (SPEP), antinuclear antibody (ANA), and rheumatoid factor (RF).
In patients with fibromyalgia without associated systemic
illnesses,
the ESR, SPEP, ANA, and RF blood tests are usually normal.
Next: What is the treatment for fibromyalgia? »
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