Testing & Diagnosis for Pediatric Fibromyalgia and Musculoskeletal Pain in Children

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There is no foolproof test for fibromyalgia, which can be frustrating when you want to know so badly what is causing your child’s pain. A further challenge is that fibromyalgia can easily be confused with or misdiagnosed as illnesses such as lupus and arthritis. This is why you and your child will likely visit a specialist -- specifically, a pediatric rheumatologist -- in order to get a diagnosis.

In 1990 the American College of Rheumatology (ACR) established two criteria for diagnosing fibromyalgia in adults:

  • widespread pain that lasts for three months or more
  • moderate pain and tenderness in 11 of 18 specific “tender points” found in the neck, shoulder, chest, hip, knee and elbow regions
     

However, most children (and some adults) feel pain in fewer than 11 tender points, which is why pediatric rheumatologists also carefully consider the type and severity of their patients’ symptoms in making a diagnosis of fibromyalgia. (And in fact, the ACR has proposed replacing the tender point test with criteria that are based more on symptoms.)

In addition to reviewing your child’s medical history and conducting a thorough physical exam, your child’s doctor may order certain blood tests to rule out other illnesses. These include:

  • Complete blood count (CBC)
  • Erythrocyte sedimentation rate (sed rate)
  • Tests for certain antibodies
  • Thyroid and liver function tests
     

Less frequently, a sleep electoencephalogram (sleep EEG) may be used to see if a child has sleep problems, which are often a sign of fibromyalgia.

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