The Tender Point Index (TPI) can be used to quantitatively evaluate the 18 pressure points used in the diagnosis of fibromyalgia.
Pressure applied at each point: 4 kilograms (using a pressure dolorimeter)
18 Pressure points - on both left and right sides (2 * 9):
(1) occiput: at the suboccipital muscle insertion
(2) low cervical: at the anterior aspect of the intertransverse spaces at C5-C7
(3) trapezius: at the midpoint of the upper border
(4) supraspinatus: at the origin, above the scapular spine near the medial border
(5) second rib: at the second costochondral junction, just lateral to the junction on the upper surface
(6) lateral epicondyle: 2 cm distal to the epicondyle
(7) gluteal: in the upper outer quadrant of the buttock in the anterior fold of the muscle
(8) greater trochanter: posterior to the trochanteric prominence
(9) knee: at the medial fat pad proximal to the joint line
Response |
Points |
---|---|
no pain |
0 |
pain without physical response |
1 |
pain with wincing or withdrawal |
2 |
pain with exaggerated withdrawal |
3 |
pain without any pressure at all |
4 |
tender point index =
= SUM(points for all 18 points)
Interpretation:
• minimum score: 0
• maximum score: 72
• The higher the score the more likely the patient has fibromyalgia.
TPI |
Interpretation |
---|---|
0 to 5 |
normal |
6 to 10 |
indeterminate |
11 to 72 |
consistent with fibromyalgia |
Purpose: To evaluate a patient for fibromyalgia using the Tender Point Index (TPI)
Specialty: Surgery, orthopedic
Objective: severity, prognosis, stage, disease progression
ICD-10: M79.7,