title: Classification and clinical diagnosis of fibromyalgia syndrome: recommendations of recent evidence-based interdisciplinary guidelines.
abstract: Objectives. Fibromyalgia syndrome (FMS), characterized by subjective complaints without physical or biomarker abnormality, courts controversy. Recommendations in recent guidelines addressing classification and diagnosis were examined for consistencies or differences. Methods. Systematic searches from January 2008 to February 2013 of the US-American National Guideline Clearing House, the Scottish Intercollegiate Guidelines Network, Guidelines International Network, and Medline for evidence-based guidelines for the management of FMS were conducted. Results. Three evidence-based interdisciplinary guidelines, independently developed in Canada, Germany, and Israel, recommended that FMS can be clinically diagnosed by a typical cluster of symptoms following a defined evaluation including history, physical examination, and selected laboratory tests, to exclude another somatic disease. Specialist referral is only recommended when some other physical or mental illness is reasonably suspected. The diagnosis can be based on the (modified) preliminary American College of Rheumatology (ACR) 2010 diagnostic criteria. Discussion. Guidelines from three continents showed remarkable consistency regarding the clinical concept of FMS, acknowledging that FMS is neither a distinct rheumatic nor mental disorder, but rather a cluster of symptoms, not explained by another somatic disease. While FMS remains an integral part of rheumatology, it is not an exclusive rheumatic condition and spans a broad range of medical disciplines.
authors.affiliation: Division of Rheumatology, McGill University Health Centre, Alan Edwards Pain Management Unit, McGill University Health Centre, Canada H3G 1A4.
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: Fitzcharles
authors.affiliation: Alan Edwards Pain Management Unit, McGill University Health Centre, Canada H3G 1A4.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Shir
authors.affiliation: Department of Rheumatology, Tel Aviv Sourasky Medical Center, 64329 Tel Aviv, Israel.
authors.forename: Jacob N
authors.initials: JN
authors.lastname: Ablin
authors.affiliation: Department of Medicine, H. Soroka Medical Center, 84101 Beer-Sheva, Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Buskila
authors.affiliation: Department of Medicine "B" and Centre for Autoimmune Diseases, Sheba Medical Centre, 52621 Tel Hashomer, Israel.
authors.forename: Howard
authors.initials: H
authors.lastname: Amital
authors.affiliation: Department Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, 66119 Saarbrücken, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Henningsen
authors.affiliation: Department Internal Medicine I, Klinikum Saarbrücken, Winterberg 1, 66119 Saarbrücken, Germany ; Department of Psychosomatic Medicine and Psychotherapy, Technische Universität München, 81865 München, Germany.
authors.forename: Winfried
authors.initials: W
authors.lastname: Häuser