Table 3. Differentiating Fibromyalgia from Illnesses with Similar Symptoms2
Illness
Rheumatic Diseases Osteoarthritis
Spondyloarthropathies, rheumatoid arthritis
Systemic lupus erythematosus, polymyalgia rheumatica
Osteomalacia Myopathy Neurologic
Multiple sclerosis, Chiari's malformation, spinal stenosis, radiculopathy
Neuropathy
Endocrine Hypothyroidism Diabetes
Other Lyme disease Hepatitis Anemia Cancers
Myofascial Pain Syndrome Tests to Differentiate from Primary Fibromyalgia Radiographs
Antinuclear antibody, rheumatoid factor, antibodies Erythrocyte sedimentation rate, C-reactive protein Vitamin D level
Creatine phosphokinase Magnetic resonance imaging Electromyography Thyroid-stimulating hormone Basic chemistry panel with fasting glucose Complete blood count, Lyme titer
Complete blood count, liver function tests Hemoglobin and hematocrit
Routine cancer screening tests, bone scan, blood chemistries specific for suspected primary cancer.
A similar but distinct entity. People with fibromyalgia may also have myofascial pain syndrome as a result of their fibromyalgia pain.
Table 4. Medical and Cognitive Features Related to Fibromyalgia2 Î Other (General)
Î Neuropsychiatric > Tension/migraine headache > Affective disorders > Restless leg syndrome/periodic limb movements/sleep apnea
Î Ear, Nose and Throat
> Sicca symptoms > Vasomotor rhinitis > Vestibular complaints
Î Cardiovascular
> Neurally mediated hypotension > Mitral valve prolapse > Noncardiac chest pain
Î Oral/Dental > Temporomandibular joint syndrome
> Paresthesias > Cognitive/memory difficulties (eg, Fibro-fog)
> Chronic fatigue syndrome > Sleep disturbances > Idiopathic low back pain > Multiple chemical sensitivity
Î Gynecological
> Vulvodynia > Chronic pelvic pain > Pre-menstrual tension
Î Gastrointestinal
> Esophageal dysmotility > Irritable bowel syndrome
Î Urological > Interstitial cystitis
