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The diagnostic tool for fibromyalgia helps determine if a person meets the criteria for a diagnosis by evaluating specific conditions. Here's how it works:

- The tool considers the Widespread Pain Index (WPI) and Symptom Severity (SS) scale scores in two scenarios:
  - WPI of 7 or more and an SS score of 5 or more.
  - WPI between 3 and 6 and an SS score of 9 or more.
  
- It also considers whether the symptoms have persisted at a similar level for at least three months.
  
- Additionally, it verifies that no other disorder explains the pain.

To determine if the diagnostic criteria are met, the tool checks the following conditions:

- The first condition is met if WPI is 7 or more, SS score is 5 or more, symptoms have persisted for three months, and no other disorder explains the pain.

- The second condition is met if WPI is between 3 and 6, SS score is 9 or more, symptoms have persisted for three months, and no other disorder explains the pain.

If either of these conditions is satisfied, the tool concludes that the diagnostic criteria for fibromyalgia are met. Otherwise, it concludes that they are not met. This approach systematically uses established measurements to assess whether a fibromyalgia diagnosis is justified based on pain index, severity, duration, and exclusion of other disorders.

The calculator in question is the Diagnostic Criteria for Fibromyalgia, developed by the American College of Rheumatology (ACR). This scoring system is used specifically for patients suspected of having fibromyalgia, a chronic condition characterized by widespread pain, fatigue, and cognitive difficulties. 

The clinical utility of this calculator is to aid in the diagnosis of fibromyalgia. It takes into account factors such as the number of painful areas in the body, the severity of symptoms like fatigue, waking unrefreshed, and cognitive symptoms, and the duration of these symptoms. 

The ACR diagnostic criteria for fibromyalgia are not meant to be used in patients with another disorder that would explain the pain, such as lupus or rheumatoid arthritis. Therefore, these conditions would be considered exclusion criteria for its use.

Diagnostic criteria for fibromyalgia

The Widespread Pain Index (WPI) calculator identifies areas on the body where pain is experienced and provides a numerical score to categorize the extent of widespread pain. The inputs include a series of boolean values corresponding to specific body regions, and each location is assigned a score of 1 if pain is present. The body areas considered are:

- Shoulder girdle (left and right)
- Upper arm (left and right)
- Lower arm (left and right)
- Hip, buttock, trochanter (left and right)
- Upper leg (left and right)
- Lower leg (left and right)
- Jaw (left and right)
- Chest
- Abdomen
- Upper back
- Lower back
- Neck

The calculator computes the WPI score by summing the values from all pain-indicated regions. Each region contributes a score of 1 if pain is present, leading to a maximum possible WPI score of 19 if all regions are affected. The total score provides a measure of how widespread the pain is across the body.

In terms of interpretation, the WPI score directly corresponds to the number of regions where pain is reported:

- A score of 1 indicates pain is present in 1 region.
- A score of 2 indicates pain is present in 2 regions.
- ...
- A score of 19 indicates pain is present in all 19 regions.

The calculated score is paired with a straightforward interpretation that mirrors the numeric score itself, stating the number of regions where pain is experienced. The system does not differentiate between levels of severity beyond the number of sites with pain. Results are returned as both the score and a textual interpretation underlining the score’s magnitude.

The Widespread Pain Index (WPI) is a clinical calculator used in the diagnosis of fibromyalgia, a chronic condition characterized by widespread pain, fatigue, and cognitive difficulties. The WPI is part of the American College of Rheumatology's (ACR) 2010 diagnostic criteria for fibromyalgia. 

The WPI applies to patients who present with chronic, widespread pain. It quantifies the number of body regions out of 19 possible areas where the patient has experienced pain in the last week. The score ranges from 0 to 19, with higher scores indicating more widespread pain.

The clinical utility of the WPI is to aid in the diagnosis of fibromyalgia, particularly in conjunction with the Symptom Severity Score (SSS). Together, these scores can help clinicians differentiate fibromyalgia from other conditions with similar symptoms.

Exclusion criteria for the use of the WPI include the presence of a disorder that would otherwise explain the pain, such as rheumatoid arthritis or lupus. It is also not applicable in acute pain situations or for localized pain conditions.

Widespread Pain Index (WPI)

The Symptom Severity (SS) scale calculator for fibromyalgia evaluates four key symptoms reported by individuals. These symptoms include fatigue, waking unrefreshed, cognitive symptoms, and somatic symptoms in general. Each symptom is assessed based on the severity level chosen by the individual, and each response is then assigned a numerical score according to a predefined scale. 

The scoring system is as follows: 

- Fatigue, Waking Unrefreshed, and Cognitive Symptoms:
  - "No problem" is assigned a score of 0.
  - "Slight or mild problems, generally mild or intermittent" is assigned a score of 1.
  - "Moderate, considerable problems, often present and/or at a moderate level" is assigned a score of 2.
  - "Severe, pervasive, continuous, life-disturbing problems" is assigned a score of 3.

- Somatic Symptoms in General:
  - "No symptoms" is assigned a score of 0.
  - "Few symptoms" is assigned a score of 1.
  - "Moderate number of symptoms" is assigned a score of 2.
  - "A great deal of symptoms" is assigned a score of 3.

The calculator collects the user's responses to these four areas, converts them into their corresponding scores, and then sums up these scores to provide a total SS score. The resulting total score can range from 0 to 12, and this total score is used for interpretation. The interpretation of the score is straightforward, with each discrete score from 0 to 12 having a direct corresponding statement of "SS score is X" where X is the total score achieved.

The Symptom Severity (SS) Scale for Fibromyalgia is a clinical calculator used to assess the severity of fibromyalgia symptoms in patients. This scale is specifically designed for patients diagnosed with fibromyalgia, a chronic condition characterized by widespread pain, fatigue, and cognitive difficulties. 

The SS scale measures the severity of the patient's symptoms over the past week, including the level of somatic symptoms, fatigue, waking unrefreshed, and cognitive symptoms. The scale ranges from 0 to 12, with higher scores indicating more severe symptoms. 

The clinical utility of this calculator is to help clinicians monitor the progression of the disease, evaluate the effectiveness of treatment strategies, and facilitate communication between the patient and healthcare provider about the patient's condition. 

There are no specific exclusion criteria for the use of the SS scale. However, it should be noted that this scale is not designed to diagnose fibromyalgia, but rather to assess symptom severity in patients already diagnosed with the condition. It may not be as useful in patients with other conditions that can mimic fibromyalgia symptoms, such as rheumatoid arthritis or lupus.

Fibromyalgia

Background

Overview

Guidelines

Key sources