Comparison of old and new criteria in fibromyalgia syndrome

The aim of this study is to compare the American College of Rheumatology (ACR) 1990 and the ACR 2010 classification criteria (ACR 1990c and ACR 2010c) in fibromyalgia syndrome. 51 fibromyalgia patients and 50 controls enrolled in this study. Fibromyalgia patients were previously diagnosed by an expert. Subjects of control group were patients with a painful noninflammatory rheumatic condition such as osteoarthritis, periarthritis, and regional pain syndromes. All patients underwent dolorimetry examination by study assessor and completed a questionnaire containing variables of both the ACR 1990c and ACR 2010c. Functional status of patients were asssessed with fibromyalgia impact questionnaire (FIQ) and mood of patients were assessed Beck depression and anxiety inventory. Complete blood count, sedimentation rate and blood serum CRP, RF, ALT, AST, ALP, calcium, phosphore, parathormone, TSH ve vitamin D levels were determined by routine laboratory methods. The sensitivity, specificity and accuracy values of the ACR 1990c were 0.74, 0.88 and 0.81, respectively, whereas the ACR 2010c values were 0.78, 0.76 and 0.77, respectively. The widespread pain index (WPI) and symptoms severity (SS) scalas showed correlations with the tender points count, FIQ, Beck depression and anxiety inventory scores. In our study, the ACR 2010c was more sensitive than the ACR 1990c, but the specificity was lower. In addition, the ACR 2010c doesn't require examination of the tender point and it is easy to assess the physical and psychological symptoms as an advantage. Therefore, the ACR 2010c could be more convenient for clinical diagnosis and follow up evaluation after starting management of fibromyalgia. Key words: Fibromyalgia, ACR 1990 criteria, ACR 2010 criteria