II. Background
- Replaced by the ACR Fibromyalgia Diagnostic Criteria (ACRFDC) in 2010 for Fibromyalgia Diagnosis
III. Indications: Fibromyalgia
- Diagnostic Criteria: 11 of 18 Tender Points
IV. Signs
- Arm and Shoulder Tender Points
- Supraspinatus tendon (above medial Scapular spine)
- Two cm distal to lateral epicondyle of elbow
- Chest Tender Points
- Costochondral junction (second rib)
- Leg Tender Points
- Posterior to greater trochanteric bursa of the femur
- Medial fat pad of the knee (proximal to joint line)
- Head and Neck Tender Points
- Suboccipital Muscle insertion
- Low cervical (anterior C5-C7 Intertransverse space)
- Back Tender Points
- Trapezius Muscle (Midpoint of upper border)
- Buttock Tender Points
- Upper outer buttocks in anterior Muscle fold
- Control Points (Non-Tender Points are non-painful)
- Mid-forehead
- Anterior Thigh
V. Differential Diagnosis: Trigger Point
- Seen in Myofascial Pain Syndrome
- Local tenderness with taut band and twitch response
- Trigger Points associated with referred pain
VI. Resources
- Tender Point Map (Fibromyalgia Support North Down)
VII. References
- Klippel (1997) Primer Rheumatic Disease, p.124-127