Fibromyalgia syndrome, more commonly known as fibromyalgia, represents a real enigma, as recently pointed out by some authors (Häuser et al, 2019). Over the past three decades, the acceptance, although not always unanimous, of the diagnosis of fibromyalgia has led to an unwarranted increase in the number of cases; in fact, guidelines accepted by the international scientific community are necessary for a correct diagnosis.
The most important complaint is chronic widespread pain along with two so-called major symptoms, fatigue and unrestorative sleep. In the 2016 review (Wolfe et al, 2016), in addition to the above criteria, the need for the patient to undergo careful medical examinations, including a history and objective assessment, was noted. Specifically, this revision combines medical criteria with those on patient-administered questionnaires, minimizes misclassification of regional pain disorders, and eliminates previous confusing recommendations regarding diagnostic exclusions. The importance of self-assessment forms in the clinical diagnosis of the individual patient, on which the previous criteria were based, is also reduced.
Although at present there are no specific laboratory tests for the diagnosis of this syndrome, careful medical examinations, especially in the fields of rheumatology and neurology, and the performance of instrumental and laboratory investigations are essential to rule out other pathologies.
Bibliography
Häuser W et al. Fibromyalgia syndrome: under-, over- and misdiagnosis, Clin Exp Rheumatol 2019; 37 (Suppl. 116): S90-S97
Wolfe F et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum, 2016; 46: 319-329.
