The American College of Rheumatology reported criteria for the diagnosis of fibromyalgia in 1990.
Patients will be said to have fibromyalgia if both of the following criteria are present. The presence of a second clinical disorder does not exclude the diagnosis of fibromyalgia.
(1) History of widespread pain present for at least 3 months. Pain is considered widespread when all of the following are present:
(1a) pain in the left side of the body
(1b) pain in the right side of the body
(1c) pain above the waist
(1d) pain below the waist
(1e) axial skeletal pain (cervical spine, or anterior chest, or thoracic spine, or low back)
(2) Pain on digital palpation in at least 11 of the following 18 sites (9 points each bilateral)
(2a) occiput: at the suboccipital muscle insertion
(2b) low cervical: at the anterior aspect of the intertransverse spaces at C5-C7
(2c) trapezius: at the midpoint of the upper border
(2d) supraspinatus: at the origin, above the scapular spine near the medial border
(2e) second rib: at the second costrochondral junction, just lateral to the junction on the upper surface
(2f) lateral epicondyle: 2 cm distal to the epicondyle
(2g) gluteal: in the upper outer quadrant of the buttock in the anterior fold of the muscle
(2h) greater trochanter: posterior to the trochanteric prominence
(2i) knee: at the medial fat pad proximal to the joint line
where:
• The digital palpation should be performed with an approximate force of 4 kilograms.
• For a point to be considered positive, the subject must state that the palpation is painful. "Tender" is not considered painful.
