Table 2.

Yunus and Masi suggested diagnostic criteria for Juvenile Primary Fibromyalgia Syndrome [3]

Major criteria

1) Generalized musculoskeletal aching at 3 or more sites for 3 or more months

2) Absence of an underlying condition/cause

3) Normal laboratory tests

4) Five or more typical tender pointsa

Minor criteria

1) Chronic anxiety or tension

2) Fatigue

3) Poor sleep

4) Chronic headaches

5) Irritable bowel syndrome

6) Subjective soft tissue swelling

7) Numbness

8) Pain modulated by physical activities

9) Pain modulated by changes in weather

10) Pain modulated by anxiety/stress

JPFS is diagnosed when all major criteria are met, plus three of the minor criteria or when there are four tender points and five minor criteria.

^aYunus and Masi listed 31 tender points. However, after the 1990 American College of Rheumatology criteria were published, most rheumatologists use the 18 tender points suggested there [101]: occiput, low cervical, trapezius, supraspinatus, second costochondral junction, lateral epicondyles, gluteal folds, posterior greater trochanter and the medial knee fat pad