Differential Diagnosis of Fibromyalgia

From Fibro Wiki
Jump to: navigation, search

Differential diagnoses Diagnostic testing options
Adrenal dysfunction Morning serum cortisol, urinary catecholamine metabolites
Anemia CBC with differential, RBC indices (MCV, MHC, MCHC)
Bone marrow disease WBC differential, ESR, CRP, CMP
Chronic fatigue syndrome Clinical history
Functional disorders (e.g., intestinal dysbiosis, subtle endocrine imbalances, and postviral immune suppression) Standard laboratory testing yields unclear results
Hypothyroidism Thyroid function tests (T3, T4, TSH)
Lyme disease Lyme titer, CMP
Psychiatric conditions (e.g., PTSD, anxiety, and depression) Refer to DSM-IV
Multiple sclerosis MRI scan, lumbar puncture, evoked potential testing
Phenomenological referred myofascial pain Muscular tender points on physical examination
Rheumatoid autoimmune disorders (e.g., rheumatoid arthritis, ankylosing spondylitis, and scleroderma) Rheumatic profile (rheumatoid factor, ESR/CRP), ANA
Sleep disorders EEG sleep studies
Spinal facet pain or sacroiliac joint pain Radiologic studies (MRI scan, CT scan), bone scans (minimal diagnostic assistance)
Spinal disc herniation MRI scan
Systemic inflammation or infection Radiologic studies (MRI scan, CT scan), bone scans (minimal diagnostic assistance)
Vitamin and/or mineral deficiency Radiologic studies (MRI scan, CT scan), bone scans (minimal diagnostic assistance)
Somatic symptom disorder with predominant persistent pain Psychiatric referral to physician who is seasoned in diagnosis of conversion disorders and hysteria
Differential diagnoses for fibromyalgia and corresponding diagnostic testing options.
Sourced from Table 1 of: Fibromyalgia Syndrome: Etiology, Pathogenesis, Diagnosis, and Treatment Enrico Bellato, Eleonora Marini, Filippo Castoldi, Nicola Barbasetti, Lorenzo Mattei, Davide Edoardo Bonasia, and Davide Blonna. Pain Res Treat. 2012; 2012: 426130. Available in full online at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503476/. This an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The caption reads: “CBC: complete blood count; RBC: red blood cell; MCV: mean corpuscular volume; MCH: mean corpuscular haemoglobin; MCHC: mean corpuscular haemoglobin concentration; WBC: white blood cell; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; CMP: complete metabolic profile; T3: triiodothyronine; T4: thyroxine; TSH: thyroid-stimulating hormone; PTSD: posttraumatic stress disorder; DSM-IV: diagnostic and statistical manual of mental disorders; ANA: antinuclear antibody; EEG: electroencephalography; MRI: magnetic resonance imaging; CT: computed tomography.”