Diagnostic Accuracy of ACR 2010 Preliminary Diagnostic Criteria in the Diagnosis of Fibromyalgia Among Chronic Backache Patients.

BACKGROUND: Chronic backache remains among common causes of attendance in orthopaedic, pain and neurology clinics and requires a detailed workup for the management of these patients. As per literature, fibromyalgia contributes to a significant number of chronic backache patients but in clinical practice, it remains a diagnosis of exclusion in the absence of definitive diagnostic workup. We need to evaluate the diagnostic accuracy of ACR 2010 preliminary diagnostic criteria for the diagnosis of fibromyalgia among chronic backache patients for use in primary and speciality care.
METHODS: The patients with chronic backache (> 3 months) attending the orthopaedic OPD were screened by the principal investigator by ACR 1990 tender point and ACR 2010 preliminary diagnostic criteria for the diagnosis of fibromyalgia. Symptoms severity assessment was done by the Fibromyalgia severity score by the principal investigator or resident doctors trained by the principal investigator.
RESULTS: Approximately 47% of patients didn't satisfy the American College of Rheumatology 1990 criteria but could be diagnosed as a case of fibromyalgia by ACR 2010 new case definition: (WPI ≥ 7 and SS ≥ 5) or (WPI ≥ 3-6 and SS ≥ 9). DISCUSSION: The patients with chronic back pain along with marked symptoms variability need consideration of Fibromyalgia for possible diagnosis especially in the absence of secondary cause for these symptoms. ACR 2010 diagnostic criteria seem compelling and effective for the diagnosis of fibromyalgia among patients with chronic back pain. © Indian Orthopaedics Association 2020.