The american college of rheumatology 1990 criteria for the classification of fibromyalgia

Abstract

Abstract To develop criteria for the classification of fibromyalgia, we studied 558 consecutive patients: 293 patients with fibromyalgia and 265 control patients. Interviews and examinations were performed by trained, blinded assessors. Control patients for the group with primary fibromyalgia were matched for age and sex, and limited to patients with disorders that could be confused with primary fibromyalgia. Control patients for the group with secondary‐concomitant fibromyalgia were matched for age, sex, and concomitant rheumatic disorders. Widespread pain (axial plus upper and lower segment plus left‐ and right‐sided pain) was found in 97.6% of all patients with fibromyalgia and in 69.1% of all control patients. The combination of widespread pain and mild or greater tenderness in ⩾ 11 of 18 tender point sites yielded a sensitivity of 88.4% and a specificity of 81.1%. Primary fibromyalgia patients and secondary‐concomitant fibromyalgia patients did not differ statistically in any major study variable, and the criteria performed equally well in patients with and those without concomitant rheumatic conditions. The newly proposed criteria for the classification of fibromyalgia are 1) widespread pain in combination with 2) tenderness at 11 or more of the 18 specific tender point sites. No exclusions are made for the presence of concomitant radiographic or laboratory abnormalities. At the diagnostic or classification level, the distinction between primary fibromyalgia and secondary‐concomitant fibromyalgia (as defined in the text) is abandoned.

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Affiliated Institutions

• University of North Dakota US
• Toronto Western Hospital CA
• University of Connecticut US
• University Hospital CA
• Wheeling Hospital US
• The University of Texas Health Science Center at San Antonio US
• Wichita State University US
• Peoria campus of the University of Illinois System US
• Grand Forks Air Force Base US
• Toledo Clinic Cancer Center US
• Sunnybrook Health Science Centre CA
• University of Kansas US
• McMaster University CA
• Oregon Health & Science University US
• North Dakota State University US
• Wellesley Institute CA

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