The diagnosis of fibromyalgia is made in patients with a history of diffuse musculoskeletal pain and which of the following physical findings:
**Core Concept**
Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties. The diagnosis of fibromyalgia is primarily based on a patient's symptom history and physical examination findings.
**Why the Correct Answer is Right**
The correct answer is tender points. In fibromyalgia, patients exhibit tender points, which are areas of increased sensitivity to pressure. These tender points are typically found in specific locations on the body, such as the neck, back, and shoulders. The presence of tender points is a key diagnostic criterion for fibromyalgia, as it helps to distinguish it from other musculoskeletal disorders.
**Why Each Wrong Option is Incorrect**
* **Option A:** Muscle spasms are not a specific diagnostic feature of fibromyalgia. While patients with fibromyalgia may experience muscle spasms, this symptom is not unique to the condition and can be found in various other musculoskeletal disorders.
* **Option B:** Limited range of motion is not a diagnostic criterion for fibromyalgia. While patients with fibromyalgia may experience stiffness or limited mobility, this symptom is not specific to the condition and can be found in various other musculoskeletal disorders.
* **Option C:** Muscle weakness is not a diagnostic feature of fibromyalgia. While patients with fibromyalgia may experience fatigue or weakness, this symptom is not specific to the condition and can be found in various other musculoskeletal disorders.
**Clinical Pearl / High-Yield Fact**
Patients with fibromyalgia often exhibit a characteristic "waxy" or " wooden" feel to their skin when palpated, particularly over tender points. This finding is due to the increased sensitivity to pressure and the presence of localized inflammation.
**Correct Answer: C. Muscle weakness is not a diagnostic feature of fibromyalgia. While patients with fibromyalgia may experience fatigue or weakness, this symptom is not specific to the condition and can be found in various other musculoskeletal disorders.