- DVBCWFI1 ;ALB/CMM FIBROMYALGIA WKS TEXT - 1 ; 6 MARCH 1997
- ;;2.7;AMIE;**12**;Apr 10, 1995
- ;
- ;
- TXT ;
- ;;Narrative: For VA compensation purposes, the diagnosis of fibromyalgia
- ;;(sometimes called fibrositis, primary fibromyalgia syndrome, or
- ;;myofascial pain syndrome) requires the presence of widespread
- ;;musculoskeletal pain and tender points. Additional findings may also
- ;;be present: fatigue, sleep disturbance, stiffness, paresthesias,
- ;;headache, irritable bowel symptoms, depression, anxiety, or Raynaud's
- ;;-like symptoms. Widespread pain is defined as pain in both the left
- ;;and right sides of the body, that is both above and below the waist,
- ;;and that affects both the axial skeleton (i.e., cervical spine,
- ;;anterior chest, thoracic spine, or low back) and the extremities.
- ;;Rule out other diagnostic entities that may be responsible for the
- ;;symptomatology presented.
- ;;
- ;;A. Review of Medical Records:
- ;;
- ;;
- ;;
- ;;B. Medical History (Subjective Complaints):
- ;;
- ;; Comment on:
- ;; 1. Date of onset of symptoms, date of diagnosis (if known).
- ;;
- ;;
- ;; 2. What precipitates and alleviates symptoms?
- ;;
- ;;
- ;; 3. Location, severity, frequency of any musculoskeletal pain,
- ;; stiffness, or muscle weakness, whether episodic or constant,
- ;; and what their effects are on daily activities.
- ;;
- ;;
- ;; 4. Unexplained fatigue, sleep disturbances.
- ;;
- ;;
- ;; 5. GI symptoms.
- ;;
- ;;
- ;; 6. Treatment, (type, duration, response). Has treatment been
- ;; continuous?
- ;;
- ;;
- ;; 7. Is there depression or anxiety?
- ;;
- ;;
- ;; 8. Lost time from work?
- ;;
- ;;
- ;;
- ;;C. Physical Examination (Objective Findings):
- ;;
- ;; Address each of the following and fully describe current findings:
- ;; (Please incorporate all ancillary study results into the final
- ;; diagnosis.)
- ;;
- ;; 1. Is the condition currently active or in remission?
- ;;
- ;;
- ;; 2. Musculoskeletal areas involved.
- ;;
- ;;
- ;; 3. Trigger or tender points.
- ;;
- ;;
- ;; 4. Muscle strength in involved areas.
- ;;
- ;;
- ;;D. Diagnostic and Clinical Tests:
- ;;
- ;; 1. Include results of all diagnostic and clinical tests conducted
- ;; in the examination report.
- ;;
- ;;
- ;;
- ;;E. Diagnosis:
- ;;
- ;;
- ;;
- ;;Signature: Date:
- ;;END
- --- Routine Detail --- with STRUCTURED ROUTINE LISTING ---[H[J[2J[HDVBCWFI1 2452 printed Feb 18, 2025@23:17:28 Page 2
- DVBCWFI1 ;ALB/CMM FIBROMYALGIA WKS TEXT - 1 ; 6 MARCH 1997
- +1 ;;2.7;AMIE;**12**;Apr 10, 1995
- +2 ;
- +3 ;
- TXT ;
- +1 ;;Narrative: For VA compensation purposes, the diagnosis of fibromyalgia
- +2 ;;(sometimes called fibrositis, primary fibromyalgia syndrome, or
- +3 ;;myofascial pain syndrome) requires the presence of widespread
- +4 ;;musculoskeletal pain and tender points. Additional findings may also
- +5 ;;be present: fatigue, sleep disturbance, stiffness, paresthesias,
- +6 ;;headache, irritable bowel symptoms, depression, anxiety, or Raynaud's
- +7 ;;-like symptoms. Widespread pain is defined as pain in both the left
- +8 ;;and right sides of the body, that is both above and below the waist,
- +9 ;;and that affects both the axial skeleton (i.e., cervical spine,
- +10 ;;anterior chest, thoracic spine, or low back) and the extremities.
- +11 ;;Rule out other diagnostic entities that may be responsible for the
- +12 ;;symptomatology presented.
- +13 ;;
- +14 ;;A. Review of Medical Records:
- +15 ;;
- +16 ;;
- +17 ;;
- +18 ;;B. Medical History (Subjective Complaints):
- +19 ;;
- +20 ;; Comment on:
- +21 ;; 1. Date of onset of symptoms, date of diagnosis (if known).
- +22 ;;
- +23 ;;
- +24 ;; 2. What precipitates and alleviates symptoms?
- +25 ;;
- +26 ;;
- +27 ;; 3. Location, severity, frequency of any musculoskeletal pain,
- +28 ;; stiffness, or muscle weakness, whether episodic or constant,
- +29 ;; and what their effects are on daily activities.
- +30 ;;
- +31 ;;
- +32 ;; 4. Unexplained fatigue, sleep disturbances.
- +33 ;;
- +34 ;;
- +35 ;; 5. GI symptoms.
- +36 ;;
- +37 ;;
- +38 ;; 6. Treatment, (type, duration, response). Has treatment been
- +39 ;; continuous?
- +40 ;;
- +41 ;;
- +42 ;; 7. Is there depression or anxiety?
- +43 ;;
- +44 ;;
- +45 ;; 8. Lost time from work?
- +46 ;;
- +47 ;;
- +48 ;;
- +49 ;;C. Physical Examination (Objective Findings):
- +50 ;;
- +51 ;; Address each of the following and fully describe current findings:
- +52 ;; (Please incorporate all ancillary study results into the final
- +53 ;; diagnosis.)
- +54 ;;
- +55 ;; 1. Is the condition currently active or in remission?
- +56 ;;
- +57 ;;
- +58 ;; 2. Musculoskeletal areas involved.
- +59 ;;
- +60 ;;
- +61 ;; 3. Trigger or tender points.
- +62 ;;
- +63 ;;
- +64 ;; 4. Muscle strength in involved areas.
- +65 ;;
- +66 ;;
- +67 ;;D. Diagnostic and Clinical Tests:
- +68 ;;
- +69 ;; 1. Include results of all diagnostic and clinical tests conducted
- +70 ;; in the examination report.
- +71 ;;
- +72 ;;
- +73 ;;
- +74 ;;E. Diagnosis:
- +75 ;;
- +76 ;;
- +77 ;;
- +78 ;;Signature: Date:
- +79 ;;END