Multiphase skeletal scintigraphy in primary fibromyalgia syndrome: a blinded study

Area of Science:

• Rheumatology
• Nuclear Medicine
• Musculoskeletal Diseases

Background:

• Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain.
• The underlying pathophysiology of FMS, particularly the presence of subclinical synovitis, remains unclear.
• Diagnostic imaging modalities are crucial for differentiating FMS from other arthritic conditions.

Purpose of the Study:

• To investigate the utility of multiphase skeletal scintigraphy in detecting subclinical synovitis and uptake abnormalities at tender points in patients with primary fibromyalgia syndrome.
• To assess whether fibromyalgia patients exhibit increased scintigraphic findings suggestive of arthritis compared to normal expectations.

Main Methods:

• A blind assessment of 16 patients diagnosed with primary fibromyalgia syndrome.
• Utilized multiphase skeletal scintigraphy to evaluate for synovitis and abnormal radiotracer uptake.
• Focused on tender point sites commonly reported by fibromyalgia patients.

Main Results:

• Normal scintigraphy results were observed in 14 out of 16 patients.
• Mild, localized abnormalities were detected in 2 patients, potentially attributed to overuse trauma.
• No significant increase in synovitis, arthritis evidence, or tender point abnormalities was found above normal expectations.

Conclusions:

• Multiphase skeletal scintigraphy does not support the presence of increased subclinical synovitis or arthritis in patients with primary fibromyalgia syndrome.
• The findings suggest that imaging-detectable joint inflammation is not a primary feature of fibromyalgia.
• Further research may explore other potential causes for tender points and pain in fibromyalgia.