Keywords for Investigation, Referral and Medical journal writing of Fibromyalgia 4.64/5 (14)

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The basis for the diagnosis Fibromyalgia

  • Chronic (daily) pain in both arms, both legs, neck and / or back
  • Painful at pressure
  • No obvious underlying disease explanation
  • Most common in adult women

Disease history

  • Chronic pain

    • Duration of pain
    • Location of pain
    • Better in warm climate
  • Treatment up to now

    • Physical
    • Exercises
    • Activity and self-training
    • Relaxation
    • heat Application
    • Medication

Clinical examination

Exclude another disease

Blood test results

  • Blood tests are expected to be normal in fibromyalgia
  • Blood tests to rule out similar conditions
    • Hemoglobin
    • White blood cells
    • CRP
    • Erythrocyte sedimentation rate (ESR)
    • Thyroid function: TSH, FT4
    • Calcium (hyper-parathyroidism)
    • Antinuclear Antibodies (ANA)
    • CCP / ACPA antibody (rheumatoid arthritis)
    • Creatine kinase (CK, myositis)
    • Vitamin B12, Methylmalonic acid, homocysteine
  • Please see also Differential diagnosis here

 Referral to specialist

  • Fibromyalgia is not an inflammatory connective tissue disease, and the referral is not usually prioritized by rheumatological hospital departments due to capacity problems
  • General practitioners are competent to investigate, diagnose and follow up patients with fibromyalgia
  • In case of a claim for specialist declarations or for special illnesses, referral to rheumatologist may be applicable
    • Hospital out-patient clinics and departments prioritize inflammatory diseases first (Right to health care)
    • References for the assessment of fibromyalgia are therefore often rejected from hospitals

Usually, the general practitioner can do Medical examination, give patient Information and start current measures. Specialists do not have special medication or other treatment options

Reference to practicing rheumatologist may be relevant where these have free capacity



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