OBJECTIVE: To characterize a scale for the measurement of fibromyalgia (FM)-like
symptoms; to investigate whether FM is a discrete disorder; to understand the significance of
FM-like symptoms; and to investigate causal and noncausal factors in the development of
such symptoms. METHODS: We evaluated 25,417 patients with rheumatic disease using the
Symptom Intensity (SI) Scale, a self-report scale that combines a count of pain in 19
nonarticular regions with a visual analog scale for fatigue. We studied this scale in relation to …

The article by Wolfe and Rasker in this issue of The Journal1 would be clearer if they
dropped any reference to the terms “fibromyalgia” or “fibromyalgia-like.” This paper is about
chronic widespread pain, fatigue, and other symptoms, as found in 25,417 patients—
nonspecific symptoms that can be found in many diseases. They do not have access to data
(counts of specifically defined “tender points”) that would allow them to apply the 1990
classification criteria for “fibromyalgia.” Their data derive from patients referred from …