‘Fibromyalgia’, which hurts the whole body for no reason, what test is needed for a differential diagnosis?

Fibromyalgia is an intractable disease that is not easy to treat as it is a chronic disease that causes pain throughout the body for more than 3 months. The main symptom of fibromyalgia is pain in the muscles of the whole body, such as arms, legs and trunk.

Recently, it is too easy to diagnose patients who complain of such muscle pain as ‘fibromyalgia’. However, there is a disease that has symptoms similar to fibromyalgia but has a different treatment method, so it is important to distinguish it correctly. It is a chronic inflammatory disease such as polymyalgia rheumatism and rheumatoid arthritis.

FibromyalgiaㅣSource: Clip Art Korea
Fibromyalgia should be distinguished from other diseases
Fibromyalgia is muscle pain that does not occur for any specific reason, so blood tests do not show any abnormalities. If the level of inflammation is higher in blood tests, it is important to check if it is an inflammatory disease such as rheumatoid arthritis or polymyalgia rheumatism. Treatment methods for rheumatoid arthritis or polymyalgia arthritis have been established, and when treated, the response to treatment is good. However, when drugs used for fibromyalgia are taken for these diseases, they may not the pain is controlled and side effects can occur.

In cases such as Sjogren’s syndrome or Behcet’s rheumatic disease, secondary fibromyalgia may appear. Patients with these conditions should pay more attention to their diagnosis, bearing in mind the possible comorbidity of fibromyalgia.

‘Joint ultrasonography’ is useful for the differential diagnosis of fibromyalgia
Joint ultrasonography is an important test in differentiating fibromyalgia from other inflammatory autoimmune diseases. In fact, many patients who have been diagnosed with fibromyalgia and receive treatment but do not improve and visit the hospital again, when a joint ultrasound is performed, show synovitis. The most important pathological finding of various rheumatic diseases is synovitis, where inflammation occurs in the synovial membrane. Therefore, when synovitis is seen, it is often diagnosed as rheumatoid arthritis or polymyalgia arthritis.

In rheumatic diseases, it is very important to make an accurate diagnosis by integrating clinical symptoms, blood tests, joint ultrasound, X-ray findings, and sometimes histological findings. After ruling out the possibility of an autoimmune inflammatory disease through these various tests, a final diagnosis of fibromyalgia should be made.

Written = Haidak Medical Reporter Wins Je-beom (Rheumatology specialist)

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