A Short Guide to Fibromyalgia

By Daniel J. Wallace; Janice Brock Wallace | Go to book overview

7
The Fibromyalgia
Consultation and
Differential Diagnosis

Fibromyalgia is usually a diagnosis of exclusion. Often poorly under⁃ stood by some primary care physicians, its diagnosis is often delayed. Even though in one survey up to 10 percent of general medical visits involve a complaint of generalized musculoskeletal pain, the diagno⁃ sis was made only after patients saw a mean of 3.5 doctors. This chap⁃ ter will take you through the workup that establishes the definitive diagnosis and eliminates other possible explanations for the patient's complaints.


WHO SHOULD BE THE FIBROMYALGIA
CONSULTANT AND HOW CAN THE PATIENT
PREPARE FOR THE VISIT?

Suppose that you are suspected of having fibromyalgia, and a primary care physician has referred you to a fibromyalgia consultant (usually a rheumatologist but sometimes an internist, physiatrist, neurologist, orthopedist, or osteopath) to confirm the diagnosis and make manage⁃ ment suggestions. Is any sort of advanced preparation advisable? Yes. Bring copies of outside records and previous test results or workups to the consultant. If you have more than a few complaints or are taking more than a few medications, a summary list is useful. The evaluation will consist of an interview, or history, physical examination, diagnos⁃ tic laboratory tests, and possibly imaging studies (X-rays, scans, etc.). Once all the observations and test results are in, the doctor will discuss the findings with you—perhaps at the time of the visit, by telephone after the initial meeting, or in a follow-up visit.

-65-

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