Juvenile fibromyalgia, a frequently missed disorder: a case report and literature review
Bibliographic record
Abstract
INTRODUCTION: The clinical features of juvenile fibromyalgia were first described by Yunus & Masi in 1985. In the US, it is estimated that about 6% of adolescents between 15 and 19 years of age suffer from juvenile fibromyalgia. However, this entity remains “a poorly defined disorder”, being excluded from the main diagnostic classification systems. OBJECTIVES: The goal of our work is to present and discuss a case-based review of juvenile fibromyalgia. METHODS: We present a case of chronic pain in pediatric age, referred to a multidisciplinary chronic pain consultation. Through the analysis of this case, we review the concept of juvenile fibromyalgia and its pathophysiology, the risk factors, the diagnostic criteria, the recent evidence for the treatment of these cases and the prognosis of this disorder. RESULTS: We describe the case of an 11-year-old female, who presented with widespread musculoskeletal pain, headaches, and sleep disturbances for a period over 3 months. At physical examination no significant alterations were found except for pain at palpation of the referred pain locations and at palpation of 11 typical fibromyalgia tender points. Complementary diagnostic exams were normal. The patient was referred to a multidisciplinary chronic pain consultation and was prescribed pharmacological therapy with antidepressants and a gabapentinoid and non-pharmacological therapy with a plan of physical exercises and psychotherapy. CONCLUSIONS: This case report demonstrates the importance of considering juvenile fibromyalgia in the differential diagnosis of pain in pediatric age, showing also the complexity involved in the assessment and treatment of these cases. This case also highlights the importance of multidisciplinary collaboration in the management of chronic pain. DISCLOSURE OF INTEREST: None Declared
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.008 | 0.006 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".