Fibromyalgia: Test and Diagnosis

The diagnosis is made by history and physical examination.

Note: Fibromyalgia is a diagnosis of exclusion!To rule out fibromyalgia, testing of the following laboratory parameters is recommended:

  • Small blood count
  • Differential blood count
  • Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate) – eg due topossible polymyalgia rheumatica, rheumatoid arthritis.
  • Creatinine kinase (CK) – due toe.g. muscle diseases.
  • Calcium – exclusion of hypercalcemia (calcium excess).
  • TSH (thyroid-stimulating hormone), basal (eg, due toHypothyroidism – hypothyroidism).
  • 25-Dihydroxy vitamin D – exclusion of vitamin D deficiency (due toassociation between FMS and 1,25-dihydroxy vitamin D deficiency (odds ratio 1.41 [95% confidence interval 1.00-2.00] after adjusting for confounding variables)]
  • Borrelia antibody (IgG, CSF/serum).
  • Yersinia antibodies (IgA, IgG, IgM)
  • CCP-Ak (cyclic citrullinated peptide) – in suspected rheumatic diseases.
  • Auto-Ak (IgG) against cell nuclear antigens (synonyms: ANA, ANF, antinuclear factors).
  • Auto-Ak against smooth muscle (synonyms: SMA, ASMA, actin).
  • Myoglobin
  • Rheumatoid factor (RF)

Depending on the history and physical examination findings, additional laboratory tests may be useful.