Summary
Definición
Anamnesis y examen
Principales factores de diagnóstico
- widespread pain and stiffness
- sleep disturbance/fatigue
- cognitive difficulties
Otros factores de diagnóstico
- allodynia and/or hyperalgesia
- diffuse tenderness on exam
- sensitivity to sensory stimuli
- headaches
- mood disturbance
- numbness/tingling sensations
Factores de riesgo
- family history of fibromyalgia (FM)
- rheumatologic conditions
- age between 20 and 60 years
- female sex
- stressful events
- sleep problems
- infections
- vitamin D deficiency
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- clinical diagnosis
Pruebas diagnósticas que deben considerarse
- erythrocyte sedimentation rate (ESR)/CRP
- thyroid function test
- CBC
- rheumatoid factor
- anti-cyclic citrullinated protein (CCP) antibody
- antinuclear antibody or anti-DNA antibody
- vitamin D level
- creatinine kinase
- ferritin
- overnight oximetry/polysomnography
Algoritmo de tratamiento
mild or moderate fibromyalgia
severe fibromyalgia
Colaboradores
Autores
Matthew A. Bartlett, MB, BCh, BAO
Assistant Professor of Medicine
Fibromyalgia Clinic
Division of General Internal Medicine
Department of Internal Medicine
Mayo Clinic
Rochester
MN
Divulgaciones
MAB declares that he owns stock in Johnson & Johnson. No products developed or marketed by Johnson & Johnson are included in this topic.
Christopher V. Anstine, MD
Assistant Professor of Medicine
Fibromyalgia Clinic
Division of General Internal Medicine
Department of Internal Medicine
Mayo Clinic
Rochester
MN
Divulgaciones
CVA declares he has no competing interests.
Agradecimientos
Dr Matthew A. Barlett and Dr Christopher V. Anstine would like to gratefully acknowledge Dr Daniel J. Clauw and Dr Lisa Ware Corbin, previous contributors to this topic.
Divulgaciones
LWC and DJC declare that they have no competing interests.
Revisores por pares
Don Goldenberg, MD
Emeritus Professor of Medicine
Tufts University School of Medicine
Boston
MA
Divulgaciones
DG declares that he has no competing interests.
Robert Bennett, MD
Professor of Medicine and Nursing Research
Oregon Health & Science University
Portland
OR
Divulgaciones
RB declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016 Dec;46(3):319-29. Resumen
Fitzcharles MA, Ste-Marie PA, Goldenberg DL, et al; Canadian Fibromyalgia Guidelines Committee. 2012 Canadian guidelines for the diagnosis and management of fibromyalgia syndrome. Aug 2012 [internet publication].Texto completo
Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017 Feb;76(2):318-28.Texto completo Resumen
Goldenberg DL, Burckhardt C, Crofford L. Management of fibromyalgia syndrome. JAMA. 2004 Nov 17;292(19):2388-95.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Rheumatoid arthritis (RA)
- Polymyalgia rheumatica (PMR)
- Systemic lupus erythematosus (SLE)
Más DiferencialesGuías de práctica clínica
- ACTTION-APS Pain Taxonomy (AAPT) diagnostic criteria for fibromyalgia
- EULAR revised recommendations for the management of fibromyalgia
Más Guías de práctica clínicaFolletos para el paciente
Fibromyalgia: what is it?
Fibromyalgia: what are the treatment options?
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