title: The impact of concomitant fibromyalgia on visual analogue scales of pain, fatigue and function in patients with various rheumatic disorders.
abstract: OBJECTIVE
  To evaluate the impact of concomitant fibromyalgia on the rating of pain, fatigue, and dysfunction, in patients with various rheumatic disorders.
  
  
  METHODS
  A cross-sectional study was carried out in a hospital-based rheumatology unit. Standard clinical and laboratory data were obtained and all patients completed questionnaires on pain, fatigue, and daily function. The rate of concomitant fibromyalgia was estimated using the 1990 American College of Rheumatology (ACR) classification criteria for fibromyalgia and the analysis concentrated on visual analogue scales (VAS).
  
  
  RESULTS
  Six hundred and eighteen visits of 383 patients with inflammatory as well as non-inflammatory rheumatic disorders were analyzed. Concomitant fibromyalgia was noted in 74 patients (23% of the cohort). Patients with rheumatic diseases and concomitant fibromyalgia had significantly higher mean VAS scores for pain, fatigue, and function (79±17, 81±18, 80±18, respectively) as compared to patients who had no features of fibromyalgia (47±28, 50±29, 44±30 respectively; all p values <0.001). The scores reported by patients with rheumatic diseases and concomitant fibromyalgia were similar to the scores obtained from patients with primary FM.
  
  
  CONCLUSIONS
  Concomitant FM is common both among patients with inflammatory and patients with non inflammatory rheumatic disorders. Concomitant FM has a remarkable impact on the severity of symptoms and, moreover, patients with concomitant FM exhibit extreme and significantly distinct levels of pain and fatigue which is as severe as that reported by patients with primary FM. It seems that fibromyalgic features dominate and become the main cause of morbidity in rheumatological patients with concomitant FM.
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine; and Assaf Harofeh Medical Center, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine, Israel. oferl@asaf.health.gov.il.
authors.forename: Ofer
authors.initials: O
authors.lastname: Levy
authors.affiliation: Assaf Harofeh Medical Center, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine, Israel.
authors.forename: Refael
authors.initials: R
authors.lastname: Segal
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine; and Assaf Harofeh Medical Center, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine, Israel.
authors.forename: Ilya
authors.initials: I
authors.lastname: Maslakov
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine; and Assaf Harofeh Medical Center, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine, Israel.
authors.forename: Andrey
authors.initials: A
authors.lastname: Markov
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine; and Assaf Harofeh Medical Center, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine, Israel.
authors.forename: Moshe
authors.initials: M
authors.lastname: Tishler
authors.affiliation: Assaf Harofeh Medical Center, Internal Medicine B, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine; and Assaf Harofeh Medical Center, Rheumatology Unit, Tel Aviv University, Sackler School of Medicine, Israel.
authors.forename: Mirit
authors.initials: M
authors.lastname: Amit-Vazina
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005356:Fibromyalgia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D011788:Quality of Life; D012216:Rheumatic Diseases / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D012720:Severity of Illness Index; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale