ESR is often recommended as a routine laboratory test in patients with fibromyalgia to rule out the presence of inflammatory disorders that may mimic symptoms. Although the ESR is usually normal in patients with fibromyalgia, it is a nonspecific measure of inflammation and mild elevations may not be meaningful.
The upper limit of normal for the ESR in women is one half their age (eg, a rate of 40 mm/hr in an 80-year-old women is normal), and in men it is one half their age minus 10.
The ESR can also be mildly elevated in obese patients. However, a high ESR may be indicative of an inflammatory disorder or occult cancer that should be thoroughly evaluated.
Routine ANA or rheumatoid factor testing in not recommended unless patients have signs or symptoms that may indicate systemic lupus erythematosus or rheumatoid arthritis. A low-titer positive ANA or rheumatoid factor level is common in the general population, so these findings may be of no clinical significance in a patient with fibromyalgia.
No histologic abnormalities are seen in fibromyalgia syndrome. The earlier belief that fibromyalgia was associated with inflammation in muscle fascia has been disproven.
For more on the workup of fibromyalgia, read here.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Herbert S. Diamond. Fast Five Quiz: How Much Do You Know About Fibromyalgia? - Medscape - Jul 18, 2016.