Article ; Online: The value of inquiring patients about local discomfort during blood pressure measurement for fibromyalgia detection. A cross-sectional study.
Seminars in arthritis and rheumatism
2023 Volume 61, Page(s) 152218
Abstract: Background: Fibromyalgia overlaps and/or mimics other rheumatic diseases and may be a confounding factor in the clinimetric assessment of these illnesses. Allodynia is a distinctive fibromyalgia feature that can be elicited during routine blood pressure ...
| Abstract | Background: Fibromyalgia overlaps and/or mimics other rheumatic diseases and may be a confounding factor in the clinimetric assessment of these illnesses. Allodynia is a distinctive fibromyalgia feature that can be elicited during routine blood pressure measurement. For epidemiological purposes fibromyalgia can be diagnosed using the 2016 Wolfe et al. criteria questionnaire. No physical examination is required. Objective: To evaluate the role of a straightforward question formulated during routine blood pressure measurement for fibromyalgia detection in a rheumatology outpatient clinic. Patients and methods: All adult patients attending our Rheumatology outpatient clinic were invited to participate. While awaiting their medical consultation, they filled-out the 2016 Wolfe et al. FM diagnostic criteria questionnaire. During the ensuing routine physical examination, the physician advanced the following guideline: "I am going to take your blood pressure; tell me if the cuff's pressure causes pain". Then, blood pressure cuff was inflated to 170 mm/Hg. Sphygmomanometry induced allodynia was defined as any local discomfort caused by blood pressure measurement. If a patient voiced any uneasiness, a follow-up dichotomic question was formulated "did it hurt much or little". Sphygmomanometry-induced allodynia was correlated with the presence of fibromyalgia according to the 2016 Wolfe diagnostic criteria. Results: Four hundred and ninety-one patients were included in the study; most of them (84%) were female. The female cohort displayed the following features: Twenty five percent had fibromyalgia. Twenty seven percent had sphygmomanometry-induced allodynia. In women, sphygmomanometry-evoked allodynia had 63% sensitivity and 84% specificity for fibromyalgia diagnosis. The area under curve was 0.751. Moreover, having "much" local pain elicitation during blood pressure testing had 23% sensitivity and 96% specificity for fibromyalgia diagnosis. Men behaved differently; 15% fulfilled the fibromyalgia diagnostic criteria, but only 2% had sphygmomanometry induced allodynia. Conclusions: Inquiring female patients about local discomfort during routine blood pressure measurement is a simple and efficient procedure for fibromyalgia detection. This undemanding approach could be implemented in all clinical settings. There is marked sexual dimorphism in the link between sphygmomanometry-induced allodynia and fibromyalgia diagnosis. The presence of fibromyalgia is almost certain in those individuals having substantial pain elicitation during blood pressure measurement. |
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| MeSH term(s) | Adult ; Male ; Humans ; Female ; Fibromyalgia/complications ; Fibromyalgia/diagnosis ; Cross-Sectional Studies ; Hyperalgesia/diagnosis ; Hyperalgesia/etiology ; Blood Pressure ; Pain Measurement/methods ; Pain ; Surveys and Questionnaires |
| Language | English |
| Publishing date | 2023-05-13 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 120247-9 |
| ISSN | 1532-866X ; 0049-0172 |
| ISSN (online) | 1532-866X |
| ISSN | 0049-0172 |
| DOI | 10.1016/j.semarthrit.2023.152218 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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