Tuesday, October 20, 2009
Narrowing the focus on fibromyalgia
If attendees at the Association of Rheumatology Health Professionals' fibromyalgia debate were expecting strident disagreement, they were likely disappointed. There were some points of disagreement, but a fair number of accord as well.
Anthony Russell, MD, of the University of Alberta, who took the anti-fibromyalgia position, listed off the long history of trendy, unexplained fibromyalgia-like illnesses and pointed out the common incidence of such symptoms. (See ACP Internist's Q&A with Frederick Wolfe for more in this vein.) Physicians shouldn't reinforce patients' perceptions that they are sick, he argued.
Leslie Crofford, MD, of the University of Kentucky, didn't disagree that fibromyalgia is only the latest name for what has been a persistent, inexplicable patient complaint. But she argued that patients benefit from having their problem labeled as fibromyalgia. A diagnosis makes patients less likely to consume additional time and resources looking for an explanation, she said, and more able to move on the managing their condition.
She also offered a suggestion to decrease the likelihood of having a similar debate about whatever disease is in style five years from now: "We will all do better if we stop the foolishness of changing the name."
Labels: fibromyalgia, rheumatology
posted by Stacey Butterfield at
11:35 AM
0 Comments
Friday, April 24, 2009
Fibromyalgia: Not just for women
Daniel Clauw, ACP Member, has a bone to pick with the American College of Rhematology's criteria for fibromyalgia.
He particularly dislikes the one which says there must be tenderness in at least 11 of 18 tender point sites to diagnose the disease. "When insurance companies come asking me about this, I say I don't know, and I don't care," said Dr. Clauw during a session on fibromyalgia this morning. "It's not even objective."
Indeed, one reason fibromyalgia is commonly--and erroneously--known as a women's disease is because women are more likely to report tender points than men, he said. It's true that the disease is 1.5 to 2 times more common in women, but there are plenty of men who have it, too--and they often go undiagnosed because of the "women only" myth.
"When males have fibromyalgia, the doctor keeps looking (for an alternate reason) until he finds a peripheral cause, like a bulging disc in the back. Then the patient gets surgery, and when that doesn't work, it's said that the patient 'failed back surgery,'....not that the surgeon failed by doing the surgery."
Labels: fibromyalgia, internal medicine 2009
posted by Jessica Berthold at
4:00 PM
1 Comments
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