title: Frequency of concomitant fibromyalgia in rheumatic diseases: Monocentric study of 691 patients.
abstract: Fibromyalgia (FM) is a confounding factor for diagnosing and assessing rheumatic disease activity. This study sought to assess the extent of this syndrome in rheumatism patients at a French rheumatology department.
  
  
  
  This monocentric epidemiological study enrolled all patients consulting due to rheumatoid arthritis (RA), spondyloarthritis (SpA), or connective tissue disease (CTD). FM diagnosis was confirmed or excluded according to the rheumatologist opinion and the 1990 American College of Rheumatology (ACR) criteria.
  
  
  
  We enrolled 691 patients, including 451 women (65.3%), with a mean age of 55.8 years (18-93). Of the enrolled patients, 325 presented with RA, 298 SpA [59 psoriatic arthritis (PsA), 137 ankylosing spondylitis (AS), 64 non-radiographic SpA (nr-SpA), and 38 peripheral SpA], and 71 CTD. The rheumatologist established FM diagnosis in 97 patients (14%), while 55 (8%) fulfilled the 1990 ACR criteria. The frequency of FM was lower in RA patients (4.9% by 1990 ACR criteria; 7.7% by expert opinion) compared to SpA (11.1% by 1990 ACR, p < 0.05; 17.5% by expert opinion, p < 0.003) and CTD (11.3% by 1990 ACR, non-significant; 28.2% by expert opinion, p < 0.001). In the SpA subgroups, FM was more common in the nr-SpA than in PsA or AS (23.9%, 9.6%, and 6.4%, by 1990 ACR, p = 0.001; 37.3%, 13.5%, and 7.2%, by expert opinion, p < 0.001).
  
  
  
  FM-like symptoms are commonly associated with rheumatic diseases. The frequency of FM is particularly high in non-radiographic axial SpA, thus raising questions about the specificity of the Assessment of SpondyloArthritis International Society (ASAS) classification criteria.
authors.affiliation: Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France.
authors.forename: Angelique
authors.initials: A
authors.lastname: Fan
authors.affiliation: Department of Biostatistics Unit, DRCI, CHU Gabriel-Montpied, Clermont-Ferrand, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Tournadre
authors.affiliation: Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Tatar
authors.affiliation: Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Malochet-Guinamand
authors.affiliation: Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Mathieu
authors.affiliation: Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Couderc
authors.affiliation: Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France.
authors.forename: Martin
authors.initials: M
authors.lastname: Soubrier
authors.affiliation: Rheumatology Department, CHU Gabriel-Montpied, Clermont-Ferrand, France. Electronic address: jjdubost@chu-clermontferrand.fr.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Dubost
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D003951:Diagnostic Errors; D016021:Epidemiologic Studies; D005260:Female; D005356:Fibromyalgia / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008947:Mixed Connective Tissue Disease / Q000453:epidemiology*; D015995:Prevalence; D012680:Sensitivity and Specificity; D025241:Spondylarthritis / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: Connective tissue diseases; Fibromyalgia; Rheumatoid arthritis; Spondyloarthritis