MR-IMAGING OF MUSCLE AND TENDER POINTS IN FIBROMYALGIA

Fibromyalgia is a syndrome manifested by chronic, diffuse musculoskele tal aching and soreness, palpable muscle tender points, and other symp toms. Standardized clinical diagnostic criteria have recently been dev eloped. Skeletal muscle has been postulated as the end organ in this d isease. Biochemical, histologic, electromyographic, and conventional r adiographic studies have demonstrated no definitive abnormality. This study sought to establish whether magnetic resonance (MR) imaging coul d demonstrate any abnormality in these patients. Eighteen patients wer e entered in the study, 14 of whom were able to complete their examina tions. T1-weighted, T2-weighted, gradient-echo, and STIR (short-tau in version-recovery) sequences were performed in all Patients, with selec ted patients examined with T1-weighted, gadopentetate dimeglumine-enha nced sequences. The trapezius and suboccipital regions were imaged in patients who, clinically, had active fibromyalgia. No abnormalities co uld be detected. The authors conclude that the conventional MR imaging used in this study was unable to depict any primary skeletal muscle a bnormality in fibromyalgia.