Functional MRI in rheumatic diseases with a focus on fibromyalgia

Pain is the most common symptom in rheumatic diseases. However, the severity of pain does not correlate with pathology. The lack of an objective test for pain results in clinicians consider pain in patients with fibromyalgia as psychological. Research over the last two decade using functional neuroimaging especially functional MRI scan have demonstrated objectively that patients with fibromyalgia were not malingering. Pain processing is complex and multiple regions of the brain are involved. One consistent finding is decrease activity in regions of the brain involved in pain inhibitory pathways suggesting this is one of the fundamental pathophysiology processes in fibromyalgia.