The Concept of Incomplete Fibromyalgia Syndrome: Comparison of
Incomplete Fibromyalgia Syndrome With Fibromyalgia Syndrome by 1990
ACR Classification Criteria and Its Implications for Newer Criteria
and Clinical Practice.
Yunus MB, Aldag JC.
From the Department of Medicine, University of Illinois College of
Medicine at Peoria, Peoria, IL.
Abstract
BACKGROUND:
The 1990 American College of Rheumatology (ACR) classification
criteria for fibromyalgia syndrome (FMS) has 2 components: (a)
widespread pain (WSP) and (b) presence of 11 or more tender points
(TP) among possible 18 sites. Some clinic patients fulfill 1 component
but not the other. We have considered these patients to have
incomplete FMS (IFMS). The purpose of this study was to examine the
clinical and psychological differences between IFMS and FMS (by 1990
ACR criteria) because such comparison may be helpful to diagnose
patients in the clinic.
METHODS:
Six hundred consecutive patients referred to our rheumatology clinic
with our diagnosis of FMS were examined by a standard protocol to
determine whether they fulfilled the 1990 criteria for FMS. Both IFMS
and FMS groups were compared in demographic, clinical, and
psychological variables using appropriate statistical methods.
RESULTS:
One hundred twelve (18.7%) patients did not satisfy the 1990 ACR
criteria and were classified as IFMS. Symptoms in IFMS and FMS were
similar, generally with less frequent and less severe symptoms in the
IFMS group. In IFMS, no significant difference was found among the WSP
and TP component subgroups. Both TP and WSP were correlated with
important features of FMS.
CONCLUSIONS:
Fulfillment of the ACR 1990 criteria is not necessary for a diagnosis
of FMS in the clinic. For diagnosis and management of FMS in the
clinical setting, IFMS patients, along with consideration of the total
clinical picture, may be considered to have FMS, albeit generally
mild.
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