Elsevier

The Journal of Pediatrics

Volume 169, February 2016, Pages 181-187.e1
The Journal of Pediatrics

Original Article
2010 American College of Rheumatology Adult Fibromyalgia Criteria for Use in an Adolescent Female Population with Juvenile Fibromyalgia

https://doi.org/10.1016/j.jpeds.2015.10.011Get rights and content

Objectives

To evaluate the utility of the 2010 American College of Rheumatology (ACR) adult fibromyalgia criteria for use in adolescents with juvenile fibromyalgia (JFM).

Study design

Participants included 47 adolescent girls diagnosed with JFM (mean age = 15.3 years) and 48 age- and sex-matched adolescents (mean age = 15.0 years) with localized chronic pain (eg, headaches or abdominal pain). A trained examiner administered the Widespread Pain Index and Symptom Severity measures and also completed a manual tender point exam. Clinicians completed a form indicating the presence of active JFM per Yunus and Masi (1985) criteria, the only available and most commonly used measure for JFM. Criterion validity analysis was performed as well as t tests comparing symptoms between JFM and controls.

Results

With the Yunus and Masi criteria used as the gold standard, the 2010 ACR fibromyalgia criteria showed a sensitivity of 89.4% and specificity of 87.5%.

Conclusion

The 2010 ACR measure appears to be a valuable tool for the identification of JFM. However, a slight modification to the 2010 ACR measure and inclusion of a clinical exam is recommended.

Section snippets

Methods

A convenience sample of pediatric patients, ages 11-17 years with a known diagnosis of active primary JFM as determined by a pediatric rheumatologist, were recruited from a tertiary care rheumatology clinic. The 1985 Yunus and Masi criteria, the most widely used criteria in pediatric clinical practice and research studies, were used to diagnose JFM. Given that symptoms of FM can wax and wane, adolescents with a known diagnosis of JFM who did not have active symptoms (ie, did not meet criteria

Results

A total of 105 eligible patients were approached, and 97 (92.4%) agreed to participate. Eight patients who were approached declined to participate primarily because of heightened pain at time of contact and/or time constraints in the day. One patient with JFM had missing data, and another patient with JFM was discovered during data examination to have not met criteria for active JFM and, therefore, both were excluded from final analysis. The final sample (N = 95) consisted of 47 patients with

Discussion

In this preliminary validation study, the 2010 ACR FM Criteria appear to have very good sensitivity (89.4%) and specificity (87.5%) for use in diagnosing JFM in adolescents. In comparison, the initial validation study for adults with FM correctly classified 88.1% of patients with FM.15 At face value, the 2010 ACR criteria offer a simplified means of diagnosing a complex condition like FM. In comparison with the previous classification criteria—either the Yunus and Masi11 or the 1990 ACR Criteria

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    Supported by the National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases (K24 AR056687 [to S.K.-Z.]). The authors declare no conflicts of interest.

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