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  • Overview
  • Widespread Pain Index
  • Symptom Severity Scale
  • Scores

2010 American College of Rheumatology (ACR) Preliminary Diagnostic Criteria for Fibromyalgia: Overview

The 2010 ACR Criteria require the assessment of 3 key elements:

  1. Presentation of widespread pain and symptoms for 3 months or more.
  2. Widespread Pain Index that assesses the number of painful body areas (HCP-administered questionnaire).
  3. Symptom Severity Scale that assesses the severity of fatigue, waking unrefreshed, and cognitive symptoms, as well as the extent of other somatic symptoms (HCP-administered questionnaire).

Reference:

  1. Wolfe F, Clauw DJ, Fitzcharles M-A, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62:600-610.

Part 1: Widespread Pain Index (WPI)

  1. The WPI is the total number of areas where the patient felt pain over the past week.
  2. After identifying the areas, add up the total number and write it in the space provided. The WPI score is between 0 and 19.
  3. The front/back body diagrams are included to help you and the patient identify areas of pain.

Part 2a: Symptom Severity (SS) Scale: levels of severity

  1. The SS score is measured by indicating the levels of SS over the past week for fatigue, waking unrefreshed, and cognitive symptoms.
  2. Choose only 1 level of severity for each category. The score for Part 2a is the sum of the numbers that correspond to the severity levels.
  3. Please note that after you calculate the score for Part 2b, you will add the scores for Parts 2a and 2b for a total SS score.

Part 2b: Symptom Severity (SS) Scale: other somatic symptoms

  1. The SS score is used to determine the extent of other somatic symptoms the patient may have experienced over the past week.
  2. After determining the quantity of somatic symptoms, use your best judgment to calculate the score that matches the quantity of those symptoms.
  3. After you have completed Part 2b, you add the scores for Parts 2a and 2b for a total SS score.

Example:

If the patient’s WPI (Part 1) was 9 and SS score (Parts 2a and 2b) was 6, then the patient would meet the ACR Preliminary Diagnostic Criteria for Fibromyalgia.

If the patient’s WPI (Part 1) was 5 and SS score (Parts 2a and 2b) was 7, then the patient would not meet the ACR Preliminary Diagnostic Criteria for Fibromyalgia.

What the patient’s score means

A patient meets the Diagnostic Criteria for Fibromyalgia if the following 3 conditions are met:

  1.  
    OR
    a.
    The WPI score (Part 1) is greater than or equal to 7 and the SS score (Parts 2a and 2b) is greater than or equal to 5.
    1.b.
    The WPI score (Part 1) is from 3 to 6 and the SS score (Parts 2a and 2b) is greater than or equal to 9.
  2. Symptoms have been present at a similar level for at least 3 months.
  3. The patient does not have a disorder that would otherwise explain the pain.
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