High frequency of fibromyalgia in patients with chronic fatigue seen in a primary care practice.

We administered a standardized history questionnaire and performed a tender point examination on 27 patients with debilitating fatigue of at least 6 months duration, seen in a primary care practice, as well as on 20 patients with fibromyalgia. Sixteen of the 27 patients with chronic fatigue met the full criteria for the working case definition of chronic fatigue syndrome (CFS). Eight patients with chronic fatigue denied having any current persistent, diffuse musculoskeletal pain, and their tender point scores were similar to those in 10 normal control subjects. In contrast, 19 patients with chronic fatigue (70%) had persistent, diffuse musculoskeletal pain. The results of their tender point examinations were similar to those of the patients with fibromyalgia. Thus, the majority of these patients with debilitating chronic fatigue, including those who met criteria for CFS, met the historical and tender point diagnostic criteria for fibromyalgia. The presence of current musculoskeletal pain will identify those CFS patients who have fibromyalgia.

[1]  James F. Jones,et al.  Chronic fatigue syndrome: a working case definition. , 1988, Annals of internal medicine.

[2]  P. Garfinkel,et al.  Depression in Patients with Neuromyasthenia (Benign Myalgic Encephalomyelitis) , 1988, International journal of psychiatry in medicine.

[3]  D. Felson,et al.  Tenderness in 75 anatomic sites. Distinguishing fibromyalgia patients from controls. , 1988, Arthritis and rheumatism.

[4]  M. Caligiuri,et al.  Phenotypic and functional deficiency of natural killer cells in patients with chronic fatigue syndrome. , 1987, Journal of immunology.

[5]  A. Komaroff,et al.  The "chronic, active Epstein-Barr virus infection" syndrome and primary fibromyalgia. , 1987, Arthritis and rheumatism.

[6]  A. Hartz,et al.  Undetected fibrositis in primary care practice. , 1987, The Journal of family practice.

[7]  A. Komaroff,et al.  Frequency of 'chronic active Epstein-Barr virus infection' in a general medical practice. , 1987, JAMA.

[8]  D. Goldenberg,et al.  Psychologic studies in fibrositis. , 1986, The American journal of medicine.

[9]  A. Bengtsson,et al.  Reduced high-energy phosphate levels in the painful muscles of patients with primary fibromyalgia. , 1986, Arthritis and rheumatism.

[10]  P. Behan,et al.  The postviral fatigue syndrome--an analysis of the findings in 50 cases. , 1985, The Journal of infection.

[11]  D. Arnold,et al.  EXCESSIVE INTRACELLULAR ACIDOSIS OF SKELETAL MUSCLE ON EXERCISE IN A PATIENT WITH A POST-VIRAL EXHAUSTION/FATIGUE SYNDROME A 31P Nuclear Magnetic Resonance Study , 1984, The Lancet.

[12]  R. Bennett,et al.  Clinical characteristics of fibrositis. I. A "blinded," controlled study of symptoms and tender points. , 1983, Arthritis and rheumatism.

[13]  D. Mazanec.  First year of a rheumatologist in private practice , 1982 .

[14]  H. Moldofsky,et al.  Induction of Neurasthenic Musculoskeletal Pain Syndrome by Selective Sleep Stage Deprivation , 1976, Psychosomatic medicine.