Fighting fibrositis.
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Biomedical subjects
Publications and source records attributed to M A Cathey.
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Tender point examinations were performed on 1520 consecutive patients with various rheumatic diseases. The mean tender point count was 2.1 (3.6 SD). Four or more tender points were found in 22.9%, 7 or more in 13.6%, 12 or more 4.3%, but 60.1% had no tender points. The tender point count increased gradually with age, reaching a maximum at age 70. Women had more tender points than men, Caucasians more than blacks or Hispanics. Isolated regional clusters of tender points occurred at the shoulder girdle in 7.8%, and the knees in 7.4%. Correlation between tender points and associated peripheral joint tenderness was poor.
Psychological status was investigated in 46 primary fibrositis (PF) patients, 32 with fibrositis occurring in association with rheumatoid arthritis (RAFIB) and in 76 control patients with rheumatoid arthritis. Groups were similar in tests of life stresses: Family Inventory of Life Events, Multidimensional Health Locus of Control, and self-motivation. Only 28% of PF and 25% of RAFIB had Minnesota Multiphasic Personality Inventory profiles classified as "normal" compared with 51-60% of controls. Both PF and RAFIB had elevated "neurotic" scales (hypochondriasis, depression, hysteria), but only PF patients had statistically significant elevations in the pychopathic deviancy, psychasthenia and paranoia scales. When the Arthritis Impact Measurement Scales were used, PF but not RAFIB patients demonstrated statistically significant elevations on the anxiety and depression scales.
We studied demographic socioeconomic and clinical characteristics of 38 patients with fibrositis (fibromyalgia) that occurred in association with rheumatoid arthritis (RAFIB) and 242 patients with rheumatoid arthritis (RA) alone. Fewer RAFIB patients were married (57.1%), and most (97.4%) were women. No statistically significant differences in income, medical expenditures or other demographic variables were identified. All measures of function, pain, disease activity and psychological status were more abnormal in RAFIB patients. The clinical characteristics that best differentiated RAFIB and RA patients were pain, depression, anxiety and erythrocyte sedimentation rate, in logistic and stepwise regression models. Evaluation of disease severity markers, including radiographic erosions and frequency of total joint replacement, suggested that disease severity in RAFIB and RA is similar.
Of 1,473 consecutive new patients seen in an outpatient rheumatology clinic, 3.7% met criteria for "primary fibrositis." Secondary fibrositis was diagnosed in 12.2% of patients with rheumatoid arthritis (RA), 15.7% of patients with primary neck and back pain syndromes and 6.7% of patients with osteoarthritis (OA). When conditions presumed to be associated with secondary fibrositis were excluded, primary fibrositis was identified in 55 of 405 patients or 13.6%. Two hundred fifteen or 14.6% of all patients had either primary or secondary fibrositis. Fibrositis may be the most common disorder seen in rheumatic disease practice after OA and RA.