The Challenges of Identifying Fibromyalgia in Adolescents

Authors

Elisha E. Peterson, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, Washington, DC, USA.
Caylynn Yao, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.
Sangeeta D. Sule, Division of Rheumatology, Children's National Hospital, Washington, DC, USA.
Julia C. Finkel, Division of Anesthesiology, Pain and Perioperative Medicine, Children's National Hospital, Washington, DC, USA.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

Case reports in pediatrics

Volume

2022

DOI

10.1155/2022/8717818

Abstract

Aim: Fibromyalgia (FM) is a noninflammatory disorder of the nervous system characterized by widespread musculoskeletal pain and somatic complaints of at least 3 months duration. There are no current diagnostic criteria for fibromyalgia in children to guide clinicians in recognition, thus leading to many subspecialty referrals and extensive imaging and tests. The purpose of this retrospective review is to compare two diagnostic criteria for juvenile fibromyalgia. Methods: A retrospective chart review of 20 children diagnosed with juvenile fibromyalgia from a singular pain physician practice was performed. Both the Yunus diagnostic criteria and the 2016 American College of Rheumatology (ACR) diagnostic criteria were applied and compared. Results: 85% of patients met criteria for fibromyalgia under both criteria. 15% of patients met only ACR criteria as the Yunus criteria excluded those with underlying conditions. Of the children who fulfilled criteria with use of both diagnostic tools, this cohort reported a high somatic symptom burden as demonstrated by the ACR symptom severity scales of 12 and satisfaction of at least 4 Yunus and Masi minor criteria on average. Widespread pain was noted with an ACR Widespread Pain Index (WPI) of 7, and tender points were 4.8 on average across the cohort. Effective therapeutic regimens among patients varied widely from medical monotherapy to multimodal treatment. Patients presented with pain for 1.8 yrs on average prior to a diagnosis. All of the cohort had a normal laboratory evaluation; half the cohort received additional imaging and testing. Conclusion: This case series suggests the need for an updated diagnostic tool for pediatric fibromyalgia to facilitate recognition and treatment.

APA Citation

Peterson, Elisha E.; Yao, Caylynn; Sule, Sangeeta D.; and Finkel, Julia C., "The Challenges of Identifying Fibromyalgia in Adolescents" (2022). GW Authored Works. Paper 809.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/809

Department

School of Medicine and Health Sciences Student Works