Everyone knows this picture. Is the map of the 18 points of fibromyalgia pain. These are the diagnostic criteria were established in 1990 by the American College of Rheumatology (ACR). You know: if they have at least 11 of 18 and are present in all four quadrants: top, bottom, left and right, and carries more than 3 months with pain, since it is already, fibromyalgia singing.
1990 These criteria were established after a study conducted by Frederick Wolfe and colleagues with 558 patients: 293 with fibromyalgia and 265 for the control group
The choice of these points has been widely criticized. Those 18 points, well may have been others, and could have been 23 instead of 18. Nor is it true that the target structure in fibromyalgia was the muscle. It is not the predominant muscle pain is pain, period. Therefore, the diagnostic criteria of 1990, were becoming obsolete as it advanced the knowledge about the disease. In fact, it was initially created to reaizar clinical trials, rather than diagnostic criteria.
Over the years, have appeared various diagnostic criteria, as an alternative to the ACR, but none has come to set.
In May 2010, the same American College of Rheumatology published a new preliminary criteria for the diagnosis of fibromyalgia. 20 years later, Wolfe and colleagues conducted a study of 829 patients previously diagnosed with fibromyalgia.
The new preliminary criteria could be divided into two parts. The first part is the Widespread Pain Index or Index widespread pain (WPI). who no longer speaks of muscle tender points, but merely refers to areas: the shoulder girdle, arm, buttock, leg ... and has a value or 19 depending on the number of zones has been selected . Each area is selected if the patient has experienced pain in the past week. The WPI is the part that more weight in the criteria, but now also takes into account the cognitive disorders, fatigue, sleep disturbance and other symptoms. 
The second is the SS Index Score or severity of symptoms, which could subdivided into two parts. The SS Score 1 takes into account the three most important after the pain: sleep, fatigue and attention disorders, memory and lightheadedness (here, the mood, despite being statistically significant and present, decided not to include) . This value can range between 0 and 9, being between o and 3 each of the 3 symptoms. 
segunsa The index of the severity of symptoms (SS Score 2) is a miscellany of symptoms: headache, itching, cramps, irritable bowel ... A list of 40 symptoms that have been in the last week, where:
if you have symptoms score 0 to 0.
between 1 and 10 the score at 1.
between 11 and 24 the score is 2.
and over 25 is a 3,
therefore the value range between 0 and 3. This is the part that has less weight in the criteria, and established according to the symptoms manifested by patients in the study of Wolfe.
They join the 1 st and 2 nd index of the severity of symptoms (SS1 + SS2) and that value will range between 0 and 12.
fibromyalgia is considered if there is widespread pain index (WPI) is of at least 7 and symptom severity index reaches 5 or whether widespread pain index (WPI) is between 3 and 6 and severity index reaches 9, ie
FIBROMYALGIA IF ...
(WPI = 7 and SS Score = 5) or
( WPI 3-6, SS = Score = 9)
Wolfe preliminary criteria for improve diagnosis in fibromyalgia, based on patients diagnosed with fibromyalgia with existing criteria that have become obsolete. However, it is closer to current knowledge. Remains to be seen if curd or to stay on the road. The fact of having no objective parameters enthusiasm seems to minimize the progress on fibromyalgia. We should get used ...
- you have fibromyalgia, provisionally.
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