Table 2.

2010 American College of Rheumatology diagnostic criteria

Criteria A patient satisfies diagnostic criteria for fibromyalgia if the following three conditions are met:

1. Widespread pain index (WPI) ≥7 and symptom severity (SS) scale score ≥5, or WPI 3∼6 and SS scale score ≥9. 2. Symptoms have been present at a similar level for at least 3 months. 3. The patient does not have a disorder that would otherwise explain the pain.

Ascertainment

1. WPI: note the number of areas in which the patient has had pain over the past week. In how many areas has the patient had pain? Score will be between 0 and 19.

Shoulder girdle, left; hip (buttock, trochanter), left; jaw, left; upper back; Shoulder girdle, right; hip (buttock, trochanter), right; jaw, right; lower back; Upper arm, left; upper leg, left; chest; neck; Upper arm, right; upper leg, right; abdomen; Lower arm, left; lower leg, left; Lower arm, right; lower leg, right.

2. SS scale score:

Fatigue Waking unrefreshed Cognitive symptoms For each of the three symptoms above, indicate the level of severity over the past week using the following scale:

0=no problem 1=slight or mild problems, generally mild or intermittent 2=moderate, considerable problems, often present and/or at a moderate level 3=severe: pervasive, continuous, life-disturbing problems Considering somatic symptoms in general, indicate whether the patient has:* 0=no symptoms 1=few symptoms 2=a moderate number of symptoms 3=a large number of symptoms

The SS scale score is the sum of the severity of the three symptoms (fatigue, waking unrefreshed, and cognitive symptoms) plus the extent (severity) of somatic symptoms in general. The final score is between 0 and 12.

*Somatic symptoms that might be considered: muscle pain, irritable bowel syndrome, fatigue/tiredness, cognitive or memory problems, muscle weakness, headache, pain/cramps in the abdomen, numbness/tingling, dizziness, insomnia, depression, constipation, pain in the upper abdomen, nausea, nervousness, chest pain, blurred vision, fever, diarrhea, dry mouth, itching, wheezing, Raynaud’s phenomenon, hives/welts, ringing in ears, vomiting, heartburn, oral ulcers, loss of/change in taste, seizures, dry eyes, shortness of breath, loss of appetite, rash, sun sensitivity, hearing difficulties, easy bruising, hair loss, frequent urination, painful urination, and bladder spasms. Adapted from the article of Wolfe et al. (Arthritis Care Res [Hoboken] 2010;62:600-10) [1].