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
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Related Studies
| Definition (AOT) | 1. Small, hypersensitive points in the myofascial tissues of the body that do not have a pattern of pain radiation. These points are a manifestation of somatic dysfunction and are used as diagnostic criteria and for monitoring treatment. 2. A system of diagnosis and treatment originally described by Lawrence Jones, DO, FAAO. |
| Concepts | Diagnostic Procedure (T060) |
| English | Jones Points, Strain-Counterstrain Points, Tender Points, Counterstrain Points |
