Transcript Fibromyalgia - Sheba Hungary Student

18 tender points of Fibromyalgia
Tender points on - The Three Graces, after Baron Jean-Baptiste Regnault, 1973, Louvre
Museum, Paris
Fibromyalgia – criteria*
- History of widespread pain
and
- Pain in 11 0f 18 tender point
sites on digital palpation
* Wolfe F, Smythe HA, Yunus MB et al. (February 1990). "The American College of
Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter
Criteria Committee". Arthritis Rheum. 33 (2): 160–72.
- Digital palpation should be
performed with an
approximate force of 4 kg
- Pain should be reported as
”mild” or more severe by the
patient
18 symmetrical tender points
at 9 specific bilateral sites

Occiput
- At the suboccipital muscle insertions

Low cervical
- At the anterior aspects of the
intertransverse spaces at C5-C7

Trapezius
- At the midpoint of the
upper border

Supraspinatus
- At origins, above the scapular spine near
the medial border

Second rib
- At the second costochondral junctions,
just lateral to the junctions
on the upper surface

Humeral lateral epicondyle
- 2 cm distal to the
epicondyles

Gluteal
- In upper outer quadrants of buttocks in
anterior fold of muscle

Greater trochanter
- Posterior to the trochanteric prominence

Knee
- At the medial fat pad
proximal to the joint line
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