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‘Fibromyalgia’ – more prevalent than we think?

Issue 38 Synovium (Spring 2013)

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This interesting epidemiological study published online in Arthritis Care and Research1 found that in a random sample of the general population the prevalence of symptoms reported sufficient to satisfy the ACR criteria for the diagnosis of fibromyalgia (updated in 2010) was 6.4%. This compares with an age- and sex-adjusted prevalence of a formal diagnosis of fibromyalgia of 1.1% in the same population. The prevalence of fibromyalgia in the whole US population is estimated to be 2% with an approximate female:male ratio of 3:1. Interestingly the ‘missing cases’ were no more likely to be women than men and had a slightly younger age distribution. This was a relatively small study of 830 participants in one American county but if the findings are replicated in other populations it does raise a number of interesting questions – for example, why are females three times more likely to receive a formal diagnosis than men with the same symptoms? Do males experience symptoms but not seek healthcare to the same extent? Or are their symptoms not recognised to the same extent by healthcare practitioners? If they are not consulting should we be looking out for more men with fibromyalgia symptoms? Would these ‘missing cases’ benefit from a diagnosis by having access to effective treatments? Or would this be intrusive medicalisation without a clear benefit to the individual? All very interesting and challenging. 

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