What criteria diagnose fibromyalgia per ACR 2016?

WPI ≥7 AND SSS ≥5, OR WPI 4-6 AND SSS ≥9. Symptoms must be generalized (≥4/5 regions), present for ≥3 months, and not better explained by other diagnosis. Pain is a symptom, not a diagnostic criterion.

What does the Symptom Severity Scale include?

SSS has two parts: (1) Fatigue, waking unrefreshed, and cognitive symptoms each rated 0-3 (total 0-9). (2) Somatic symptom checklist (headache, pain/cramps, depression) scored 0-3. Total SSS 0-12.

Can fibromyalgia coexist with inflammatory arthritis?

Yes. Fibromyalgia occurs in 10-30% of RA, SLE, and AS patients. Co-occurring fibromyalgia inflates disease activity scores (DAS28, SLEDAI) and may lead to inappropriate therapy escalation if not recognized.

ACR 2010/2016 Fibromyalgia Diagnostic Criteria

Apply ACR 2016 fibromyalgia diagnostic criteria using Widespread Pain Index (WPI) and Symptom Severity Scale (SSS). No tender point exam required. Identifies fibromyalgia as a spectrum condition independent of other diagnoses.

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