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      Thermal imaging ruled out as a supplementary assessment in patients with fibromyalgia: A cross-sectional study

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          Abstract

          Background

          The diagnosis of fibromyalgia syndrome (FMS) syndrome is often complicated and relies on diagnostic criteria based mostly on the symptoms reported by patients. Implementing objective complementary tests would be desirable to better characterize this population.

          Objective

          The purpose of this cross-sectional study was to compare the skin temperature at rest using thermography in women with FMS and healthy women.

          Methods

          Eighty-six women with FMS and 92 healthy controls volunteered to participate. The temperature of all participants was measured by infra-red thermography, registering the skin surface temperature (minimum, maximum and average) at rest in different areas: neck, upper and lower back, chest, knees and elbows. In order to analyze the differences in the skin temperature between groups, inferential analyses of the data were performed using Mann-Whitney U test.

          Results

          The results showed no significant difference in skin temperature between groups in the neck, upper back, chest and elbows (p>0.05). The lower back and knees areas showed significant differences between groups (p<0.05), although these differences did not reach a minimum of clinically detectable change.

          Conclusions

          Women with fibromyalgia presented no clinically meaningful reduction or difference in skin temperature at rest when compared with a group of healthy women. The infra-red thermography is not an effective supplementary assessment tool in women with fibromyalgia.

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          Most cited references58

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          The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity.

          To develop simple, practical criteria for clinical diagnosis of fibromyalgia that are suitable for use in primary and specialty care and that do not require a tender point examination, and to provide a severity scale for characteristic fibromyalgia symptoms. We performed a multicenter study of 829 previously diagnosed fibromyalgia patients and controls using physician physical and interview examinations, including a widespread pain index (WPI), a measure of the number of painful body regions. Random forest and recursive partitioning analyses were used to guide the development of a case definition of fibromyalgia, to develop criteria, and to construct a symptom severity (SS) scale. Approximately 25% of fibromyalgia patients did not satisfy the American College of Rheumatology (ACR) 1990 classification criteria at the time of the study. The most important diagnostic variables were WPI and categorical scales for cognitive symptoms, unrefreshed sleep, fatigue, and number of somatic symptoms. The categorical scales were summed to create an SS scale. We combined the SS scale and the WPI to recommend a new case definition of fibromyalgia: (WPI > or =7 AND SS > or =5) OR (WPI 3-6 AND SS > or =9). This simple clinical case definition of fibromyalgia correctly classifies 88.1% of cases classified by the ACR classification criteria, and does not require a physical or tender point examination. The SS scale enables assessment of fibromyalgia symptom severity in persons with current or previous fibromyalgia, and in those to whom the criteria have not been applied. It will be especially useful in the longitudinal evaluation of patients with marked symptom variability.
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            2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria.

            The provisional criteria of the American College of Rheumatology (ACR) 2010 and the 2011 self-report modification for survey and clinical research are widely used for fibromyalgia diagnosis. To determine the validity, usefulness, potential problems, and modifications required for the criteria, we assessed multiple research reports published in 2010-2016 in order to provide a 2016 update to the criteria.
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              Fibromyalgia: a clinical review.

              Fibromyalgia is present in as much as 2% to 8% of the population, is characterized by widespread pain, and is often accompanied by fatigue, memory problems, and sleep disturbances.
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                Author and article information

                Contributors
                Role: Data curationRole: InvestigationRole: MethodologyRole: Writing – original draft
                Role: Data curationRole: Formal analysis
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Writing – original draft
                Role: Data curation
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                16 June 2021
                2021
                : 16
                : 6
                : e0253281
                Affiliations
                [1 ] Department of Physiotherapy, University of Valencia, Valencia, Spain
                [2 ] Faculty of Physiotherapy, Department of Physiotherapy, UBIC Research Group, University of Valencia, Valencia, Spain
                University of Würzburg, GERMANY
                Author notes

                Competing Interests: No authors have competing interests.

                Author information
                https://orcid.org/0000-0002-2752-6999
                https://orcid.org/0000-0002-0743-3445
                Article
                PONE-D-21-00758
                10.1371/journal.pone.0253281
                8208560
                34133467
                05713845-3a86-4f65-bf27-99aea234cf04
                © 2021 Sempere-Rubio et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 8 January 2021
                : 29 May 2021
                Page count
                Figures: 1, Tables: 2, Pages: 12
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100011596, Conselleria d’Educació, Investigació, Cultura i Esport;
                Award ID: GV2016/140
                This work was supported by Conselleria d’Educació, Ciència i Esports [Valencian Regional Department of Education, Science and Sports], València, Spain [Grant GV2016/140]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Neuromuscular Diseases
                Fibromyalgia
                Medicine and Health Sciences
                Neurology
                Neuromuscular Diseases
                Fibromyalgia
                Medicine and Health Sciences
                Rheumatology
                Fibromyalgia
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Temperature
                Skin Temperature
                Biology and Life Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Skeletal Joints
                Knees
                Medicine and Health Sciences
                Anatomy
                Musculoskeletal System
                Skeleton
                Skeletal Joints
                Knees
                Biology and Life Sciences
                Anatomy
                Body Limbs
                Legs
                Knees
                Medicine and Health Sciences
                Anatomy
                Body Limbs
                Legs
                Knees
                Medicine and Health Sciences
                Clinical Medicine
                Signs and Symptoms
                Pain
                Biology and Life Sciences
                Immunology
                Immune Response
                Inflammation
                Medicine and Health Sciences
                Immunology
                Immune Response
                Inflammation
                Medicine and Health Sciences
                Clinical Medicine
                Signs and Symptoms
                Inflammation
                Biology and Life Sciences
                Anatomy
                Neck
                Medicine and Health Sciences
                Anatomy
                Neck
                Biology and Life Sciences
                Physiology
                Sensory Physiology
                Somatosensory System
                Pain Sensation
                Biology and Life Sciences
                Neuroscience
                Sensory Systems
                Somatosensory System
                Pain Sensation
                Research and Analysis Methods
                Research Assessment
                Research Errors
                Custom metadata
                All relevant data are within the paper and its Supporting information files.

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