Melissa Congdon, MD, FAAP || Fibromyalgia, Fatigue, and Chronic Pain Specialist and Consultant || Marin County and the San Francisco Bay Area, California

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The American College of Rheumatology
New Clinical Fibromyalgia Diagnostic Criteria - Part 1

Pain during past week


    Symptom Severity Score (SS score) – Part 2a

    Indicate your level of symptom severity over the past week using the following scale:

    0 = No problem1 = Slight or mild problems generally mild or intermittent2 = Moderate; considerable problems often present and/or at a moderate level3 = Severe; pervasive, continuous life disturbing problems
    0 = No problem1 = Slight or mild problems generally mild or intermittent2 = Moderate; considerable problems often present and/or at a moderate level3 = Severe; pervasive, continuous life disturbing problems
    0 = No problem1 = Slight or mild problems generally mild or intermittent2 = Moderate; considerable problems often present and/or at a moderate level3 = Severe; pervasive, continuous life disturbing problems

    Symptom Severity Score (SS score) – Part 2b

    Check each of the following OTHER SYMPTOMS you have experienced over the past week:
    Muscle painIrritable bowel syndromeFatigue/tirednessThhinking or remembering problemMuscle weaknessHeadachePain/cramps in abdomenNumbness/tinglingDizzinessInsomniaDepressionConstipationPain in upper abdomenNausea
    NervousnessChest painBlurred visionFeverDiarrheaDry mouthItchingWheezingRaynauld’sHives/weltsRinging in earsVomitingHeartburnOral ulcers
    Loss/change in tasteSeizuresDry eyesShortness of breathLoss of appetiteRashSun sensitivityHearing diffcultiesEasy bruisingHair lossFrequent urinationPainful urinationBladder spasms

    Count up the number of symptoms checked above.


    This is your Symptom Severity Score (SS score), which can range from 0-12.

    If you tallied…


    0 symptoms: give yourself a score of 0
    1 to 10: give yourself a score of 1
    11 to 24: give yourself a score of 2
    25 or more: give yourself a score of 3



    A patient meets the diagnostic criteria for fibromyalgia
    if the following 3 conditions are met:
    1. The WPI score (Part 1) is greater than or equal to 7 AND
    the SS score (Part 2a & 2b) is greater than or equal to 5.

    OR

    1b. The WPI score (Part 1) is from 4 to 6 AND the SS score
    (Part 2a & 2b) is greater than or equal to 9.

    2. The symptoms have been present at a similar level for at
    least 3 months.
    For example:

    If your WPI (Part 1) was 9 and your SS score (Parts 2a and 2b)
    was 6, then you would meet the new FM diagnostic criteria.

    If your WPI (Part 1) was 5 and your SS score (Parts 2a and 2b)
    was 7, then you would NOT meet the new FM diagnostic
    criteria.

    References:

    https://www.rheumatology.org/Portals/0/Files/2010_Preliminary_Diagnostic_Criteria.pdf

    https://www.fai2r.org/wp content/uploads/2018/11/Anx_tuto_fibromyalgie_FAI2R-wolfe2016.pdf

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    How to Recognize Pediatric Fibromyalgia
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    Fibromyalgia in Children with Dr. Melissa Congdon

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    About Your Instructor

    Melissa Congdon MD

    Fibromyalgia physician for children and adults

    Dr. Congdon practiced general pediatrics in Glendale, California and Mill Valley, California for 18 years until severe fibromyalgia symptoms forced her to retire from medical practice in 2008. Her diagnosis led her to a comprehensive study of the various treatment options for fibromyalgia. Using a combination of diet, exercise, acupuncture, supplements, medications, the guaifenesin protocol, and other modalities, she was able to return to medical practice in 2009, and chose to become a fibromyalgia consultant. She trained with fibromyalgia expert and author Dr. R. Paul St. Amand, Internist, Endocrinologist, and Associate Professor at the Harbor UCLA Medical Center.

    Since 2009 Dr. Congdon has treated hundreds of children and adults with fibromyalgia. She has delivered the keynote address at both the Hawaii and Colorado Springs Fibromyalgia Summits, and has been interviewed on two podcasts. Dr. Melissa Congdon is board certified in pediatrics, and sees children and adults in her fibromyalgia and pediatric consulting practice.

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