PREVALENCE OF FIBROMYALGIA SYNDROME (FMS) AMONG WOMEN

Background: The aim of the study is to find the incidence of fibromyalgia in orthopaedic female outpatient department in a medical college hospital Methods: Cross-sectional study conducted on the female patients coming to orthopedic outpatient department. Results: The result showed that about 42.00% patients diagnosed with fibromyalgia syndrome (FMS). The age group that is majorly affected by fibromyalgia is between 40-60 years of age. Married women accounts to the major group of 89% Conclusion: We concluded that the most common diagnosis made in an orthopaedic female outpatient department is fibromyalgia


Introduction
There is a general belief that the most common diagnosis made in an orthopaedic female outpatient department is fibromyalgia. Though fibromyalgia is a common diagnosis, there are very few papers pertaining to that. Fibromyalgia is a syndrome characterised by chronic widespread pain at multiple tender points, joint stiffness, and systemic symptoms (e.g., mood disorders, fatigue, cognitive dysfunction, and insomnia) without a welldefined underlying organic disease. Associated with specific diseases such as rheumatic pathologies, psychiatric or neurological disorders, infections, and diabetes. 1,2 The aim of the study is to find the incidence of fibromyalgia in orthopaedic female outpatient department in a medical college hospital.

Inclusion criteria-
The female patients coming to orthopedic outpatient department

Exclusion criteria
The pediatric female, fresh fracture cases, post-operative follow up cases.
The assessment of fibromyalgia is based on the criteria for the classification of fibromyalgia by the American College of Rheumatology, (ACR) 1990.5-7 The criterion involves, history of widespread pain has been present for at least three months. Pain in both sides of the body pain above and below the waist. Pain is considered widespread when all of the following are present, pain in 11 of 18 tender point sites on digital palpation (both side of the body): occiput (2), low cervical (2), trapezius (2), supraspinatus (2), second rib (2), lateral epicondyle (2), gluteal (2), greater trochanter (2), knee (2). A tender point hurts only at the area where pressure (enough to cause the examiner's nail bed to blanch, or about 4 kg) is applied, and there is no referred pain. The result showed that about 42.00% patients diagnosed with fibromyalgia syndrome (FMS). The age group that is majorly affected by fibromyalgia is between 40-60 years of age. Married women accounts to the major group of 89%

Discussion
Fibromyalgia is the most common chronic widespread pain condition, it is often under diagnosed. The diagnosis of Ashok Meena et al.

International Journal of Medical and Biomedical Studies (IJMBS)
fibromyalgia has been shown to increase patient satisfaction and reduce healthcare utilisation.
In 1904, Gowers coined the term "fibrositis" which was used until the seventies and eighties of the last century when an aetiology involving the central nervous system was discovered. 5 In 1950 Graham introduced the modern concept of fibromyalgia as "pain syndrome" in the absence of a specific organic disease. Smythe and Moldofsky in mid-1970's coined "fibromyalgia" and identified the tender points. However, it is still a poorly understood condition that is difficult to diagnose. 6 Different hypotheses on the aetiology of fibromyalgia have been suggested. [7][8][9][10][11] It has also been argued that fibromyalgia is too heterogeneous a condition to consider only one single aetiology, and it has been questioned whether it is a disease entity or one end of a continuous spectrum of pain. [12][13][14] The result of this study indicates high prevalence of fibromyalgia about 42.00%. From the interpretation of all the data collected, married unskilled women between the ages of 40-60 years are the ones with highest incidence. The advantage of my study is large study group. The disadvantage is that the study group population is confined to patients coming to single institute and not that of generalised population. Majority of patients visiting the study institute are south Indian population. Since it is medical college outpatient department, medicines are given at a subsidised cost to the patient. Most of the patients coming for diabetic, hypertension and other illness tend to come to orthopaedic outpatient department for analgesics. Hence there is a little risk of malingering which may affect the result.

Conclusion
We concluded that the most common diagnosis made in an orthopaedic female outpatient department is fibromyalgia.