The Great Mimicker

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Because fibromyalgia is a syndrome which a range of symptoms and severities, and because there are dozens of known co-morbidities, it is easily misdiagnosed.

Syphilis has been called the great mimicker, but fibromyalgia is another. As far back as 1929, Murray et al. wrote about a condition referred to a “myofibrositis”. (Myofibrositis as simulator of other maladies. Murray G: Lancet Jan. 1929, 1:113–116, partially visible online at: http://www.sciencedirect.com/sdfe/pdf/download/eid/1-s2.0-S0140673600824319/first-page-pdf.) This seems to be an old name for fibromyalgia. Murray warned that it could simulate other conditions including inflammatory disorders. This problem has been so serious that one of the most common old names for fibromyalgia was “fibrositis”. This means “inflammation of the fibrous tissues”. It is now known that this name is totally misleading.

Pitfalls seen by the author include a misdiagnosis of costochondritis, and a misdiagnosis of tennis elbow. The former can occur when the doctor presses on the chest wall and finds tenderness which is assumed to be due to inflammation, but is in fact due to pressing on a chest wall tender point. Similarly, tennis elbow can be misdiagnosed when pressing on a lateral epicondylar tender point.

The Fibromyalgia—Chronic Fatigue Syndrome Continuum:

Fibromyalgia is a syndrome that is clinically on a continuum with chronic fatigue syndrome (CFS). The main difference is that in fibromyalgia, muscular pain in more prominent and in CFS, fatigue is more prominent