The 18 (9 X 2) Diagnostic Pts in Fibromyalgia

[Guest guest]

Thanks Phil.

amy

 

 

 

[Guest guest]

Hi All,

 

From http://www.acupuncturetoday.com/archives2005/mar/03wang.html

 

Dx feature of fibromyalgia on physical examination is demonstration of

specific tender points, which are exclusively more tender or painful than

adjacent areas.

 

ACR criteria for fibromyalgia defines 18 tender points (18 Diagnostic Pts

in Fibromyalgia) are:

* BL10-Tianzhu: at insertion of suboccipital m at base of skull

* ST09-Renying: at ant aspect of intertransverse processes at

C5-C7

* GB21-Jianjing: atmidpoint of upper border of trapezius m, c.

halfway between GV14 & TH14

* SI12-Bingfeng: above scapular spine near med edge of scapula

* ST15-Wuyi: in ICS 2, directly above nipple (in ICS4)

* LI11-Quchi: in lat elbow crease near lat epicondyle

* BL52-Zhibian: 3 " lat to GV line, lat to sacral foramen 4; [original

article said Pt is in upper outer quadrant of buttocks and called

the Pt BL52-Zhishi; that must be an error because BL52 is lat to

BL23-Shenshu (between transverse processes of L2-L3)]

* GB30-Huantiao: behind femoral trochanter, c. 1/3 distance

between trochanter and lumbo-sacral space

* SP10-Xuehai: in fat pad of medial knee; with palm on patella

and fingers pointing cranially, Pt is where thumb falls inside &

above knee

 

Best regards,

 

HOME + WORK: 1 Esker Lawns, Lucan, Dublin, Ireland

Tel: (H): +353-(0) or (M): +353-(0)

<

 

 

 

" Man who says it can't be done should not interrupt man doing it " -

Chinese Proverb

 

 

 

[Guest guest]

Hi Phil - are you/ACR suggesting these pts are used for diagnosis, or do

you treat these pts?

Karen

 

wrote:

 

>Hi All,

>

>>From http://www.acupuncturetoday.com/archives2005/mar/03wang.html

>

>Dx feature of fibromyalgia on physical examination is demonstration of

>specific tender points, which are exclusively more tender or painful than

>adjacent areas.

>

>ACR criteria for fibromyalgia defines 18 tender points (18 Diagnostic Pts

>in Fibromyalgia) are:

>* BL10-Tianzhu: at insertion of suboccipital m at base of skull

>* ST09-Renying: at ant aspect of intertransverse processes at

> C5-C7

>* GB21-Jianjing: atmidpoint of upper border of trapezius m, c.

> halfway between GV14 & TH14

>* SI12-Bingfeng: above scapular spine near med edge of scapula

>* ST15-Wuyi: in ICS 2, directly above nipple (in ICS4)

>* LI11-Quchi: in lat elbow crease near lat epicondyle

>* BL52-Zhibian: 3 " lat to GV line, lat to sacral foramen 4; [original

> article said Pt is in upper outer quadrant of buttocks and called

> the Pt BL52-Zhishi; that must be an error because BL52 is lat to

> BL23-Shenshu (between transverse processes of L2-L3)]

>* GB30-Huantiao: behind femoral trochanter, c. 1/3 distance

> between trochanter and lumbo-sacral space

>* SP10-Xuehai: in fat pad of medial knee; with palm on patella

> and fingers pointing cranially, Pt is where thumb falls inside &

> above knee

>

>Best regards,

>

>HOME + WORK: 1 Esker Lawns, Lucan, Dublin, Ireland

>Tel: (H): +353-(0) or (M): +353-(0)

><

>

>

>

> " Man who says it can't be done should not interrupt man doing it " -

>Chinese Proverb

>

>

>

[Guest guest]

Thanks for this Phil. It's nice to have the tender points associated with

acupuncture point locations. For a medical diagnosis of fibromyalgia, the

patient

must prove tender on 11 of these 18 points. It should also be noted that

fibromyalgia patients are tender on far more locations than these 18 indicated

points alone - indeed, the pain is often in the entire body, with some areas

more

painful than others. This is important, for whoever advocated needling

specifically on the diagnostic tender points.

 

The medical test for tenderness on these points is quite specific (a certain

amount

of pressure applied brings a certain patient response), but the pressure is

applied

manually, so it seems to me that there is a fair amount of subjectivity involved

on

the doc's part.

 

 

 

--- < wrote:

 

> Hi All,

>

> From http://www.acupuncturetoday.com/archives2005/mar/03wang.html

>

> Dx feature of fibromyalgia on physical examination is demonstration of

> specific tender points, which are exclusively more tender or painful than

> adjacent areas.

>

> ACR criteria for fibromyalgia defines 18 tender points (18 Diagnostic Pts

> in Fibromyalgia) are:

> * BL10-Tianzhu: at insertion of suboccipital m at base of skull

> * ST09-Renying: at ant aspect of intertransverse processes at

> C5-C7

> * GB21-Jianjing: atmidpoint of upper border of trapezius m, c.

> halfway between GV14 & TH14

> * SI12-Bingfeng: above scapular spine near med edge of scapula

> * ST15-Wuyi: in ICS 2, directly above nipple (in ICS4)

> * LI11-Quchi: in lat elbow crease near lat epicondyle

> * BL52-Zhibian: 3 " lat to GV line, lat to sacral foramen 4; [original

> article said Pt is in upper outer quadrant of buttocks and called

> the Pt BL52-Zhishi; that must be an error because BL52 is lat to

> BL23-Shenshu (between transverse processes of L2-L3)]

> * GB30-Huantiao: behind femoral trochanter, c. 1/3 distance

> between trochanter and lumbo-sacral space

> * SP10-Xuehai: in fat pad of medial knee; with palm on patella

> and fingers pointing cranially, Pt is where thumb falls inside &

> above knee

>

> Best regards,

>

> HOME + WORK: 1 Esker Lawns, Lucan, Dublin, Ireland

> Tel: (H): +353-(0) or (M): +353-(0)

> <

>

>

>

> " Man who says it can't be done should not interrupt man doing it " -

> Chinese Proverb

>

>

>

[Guest guest]

Hi Karen, & All,

 

> Hi Phil - are you/ACR suggesting these pts are used for diagnosis, or

> do you treat these pts? Karen

 

I have no personal expereince of using the 18 diagnostic points from

http://www.acupuncturetoday.com/archives2005/mar/03wang.html

 

I assume that they are mainly used in diagnosis, but if Constitutional /

TCM acupoint selection does NOT release these points, I assume that

one might release them by direct needling, as in trigger-point therapy.

 

Best regards,