ACR Fibromyalgia Diagnostic Criteria

Aka: ACR Fibromyalgia Diagnostic Criteria, ACRFDC, Widespread Pain Index, Fibromyalgia Diagnosis

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II. Background

  1. Replaces Tender Points in the diagnosis of Fibromyalgia as of 2010

III. Criteria

  1. Instructions
    1. Part 1: Patient checks boxes on a diagram of a person from back)
    2. Parts 2 and 3: Questions answered without diagram
  2. Part 1: Over the last 7 days, indicate the areas where you have had pain or tenderness
    1. See Tender Points
    2. Neck
    3. Upper Back
    4. Chest or Breast
    5. Abdomen
    6. Lower Back
    7. Left jaw
    8. Left Shoulder
    9. Left upper arm
    10. Left lower arm
    11. Left hip
    12. Left upper leg
    13. Left lower leg
    14. Right jaw
    15. Right Shoulder
    16. Right upper arm
    17. Right lower arm
    18. Right hip
    19. Right upper leg
    20. Right lower leg
  3. Part 2: Over the last 7 days, rate your symptoms based on the following scale
    1. Rating scale
      1. Points 0: No problem
      2. Points 1: Slight or mild
      3. Points 2: Moderate (considerable problems)
      4. Points 3: Severe (life-disturbing problems)
    2. Questions
      1. Fatigue
      2. Trouble thinking or remembering
      3. Waking up tired or unrefreshed
  4. Part 3: Over the last 6 months, have you had any of the following symptoms
    1. Score 1 for 1-10 positive, 2 for 11-24 positive or 3 for 25 or more
    2. Fever
    3. Depressed Mood
    4. Insomnia
    5. Nervousness
    6. Hair Loss
    7. Headache
    8. Seizures
    9. Thinking or memory problem
    10. Numbness of tingling
    11. Dizziness
    12. Fatigue
    13. Hearing problems
    14. Ringing in the ears (Tinnitus)
    15. Blurred Vision
    16. Dry Eyes
    17. Dry Mouth
    18. Oral Ulcers
    19. Shortness of Breath
    20. Chest Pain
    21. Heartburn
    22. Pain in upper Abdomen
    23. Pain or cramps in the lower Abdomen
    24. Nausea
    25. Vomiting
    26. Diarrhea
    27. Constipation
    28. Loss of appetite
    29. Loss or change in taste
    30. Irritable Bowel Syndrome
    31. Bladder spasms
    32. Frequent Urination
    33. Painful urination
    34. Easy Bruising
    35. Hives
    36. Itching
    37. Rash
    38. Sun sensitivity
    39. Raynaud Phenomenon
    40. Muscle pain
    41. Muscle Weakness

IV. Scoring

  1. Widespread Pain Index (WPI)
    1. Part 1: Total the number of areas of tenderness or pain (out of 19 possible)
  2. Symptom Score (SS)
    1. Total the points from parts 2 and 3 (out of 12 possible)
    2. Part 2: Total the number of points from the 3 questions (assign 0-3 points for each of the 3 questions)
    3. Part 3: Assign 1 point for each of the 3 questions that are positive

V. Interpretation: Diagnosis of Fibromyalgia

  1. Criteria 1
    1. Widespread Pain Index (WPI): 7 of 19 and
    2. Symptom Score (SS): 5 of 12
  2. Criteria 2
    1. Widespread Pain Index (WPI): 3-6 of 19 and
    2. Symptom Score (SS): 9 of 12

VI. References

  1. Wolfe (2010) Arthritis Care Res 62(5): 600-10 [PubMed]

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