Misdiagnosis in fibromyalgia: a multicentre study

Area of Science:

• Rheumatology
• Clinical Diagnosis
• Medical Research

Background:

• Fibromyalgia (FM) is a common condition seen by rheumatologists, frequently presenting diagnostic challenges.
• Misdiagnosis or delayed diagnosis of FM is a significant issue, impacting patient care.
• FM is often associated with other rheumatic disorders, complicating its identification.

Purpose of the Study:

• To investigate the underdiagnosis of fibromyalgia.
• To identify rheumatic diseases that are commonly confused with fibromyalgia.
• To improve diagnostic accuracy for fibromyalgia.

Main Methods:

• Collected baseline data including symptoms, disease duration, physical examination findings, and investigations.
• Utilized clinimetric evaluations such as the Fibromyalgia Impact Questionnaire (FIQ) and Fibromyalgia Assessment Status (FAS).
• Analyzed data from 427 outpatients to compare characteristics of correctly diagnosed FM patients with those misdiagnosed with musculoskeletal disorders (MSDs).

Main Results:

• Out of 427 patients, 13.3% were initially misdiagnosed with other musculoskeletal disorders (MSDs).
• Patients with MSDs had longer disease duration and higher erythrocyte sedimentation rates compared to FM patients.
• Fibromyalgia Impact Questionnaire (FIQ) and Fibromyalgia Assessment Status (FAS) scores showed correlation in the MSD group.

Conclusions:

• Fibromyalgia, despite being a recognized clinical entity, presents ongoing diagnostic challenges.
• Differentiating fibromyalgia from spondyloarthropathies (SpA), connective tissue disease (CTD), and inflammatory arthritis remains difficult for clinicians.
• Accurate differential diagnosis is crucial for effective management of fibromyalgia and related rheumatic conditions.