Avoiding Diagnostic Overshadowing: A Case Series on Cervical Myelopathy in Patients with Fibromyalgia.
Paddison R Lowe, Brandon B Carlson, Andrea L Chadwick
✦ AI-curated · Sources linked
Case in brief
Three patients referred to a multidisciplinary chronic pain clinic for fibromyalgia evaluation had substantial physical and neurological impairment. Clinical and radiographic assessment identified unrecognized cervical myelopathy. The report emphasizes that fibromyalgia can coexist with other conditions causing overlapping symptoms; severe or progressive neurological dysfunction and upper motor neuron signs should not be attributed to fibromyalgia alone. The abstract does not specify the patients’ treatments or outcomes.
What made this case unusual
The diagnostic pitfall was attributing significant neurological dysfunction and severe physical limitations to fibromyalgia, delaying recognition of cervical myelopathy in patients referred specifically for fibromyalgia care.
Diagnostic / clinical pearl
In a patient with fibromyalgia, severe or progressive neurological symptoms, marked functional limitation, or upper motor neuron signs warrant a thorough neurological examination and further evaluation, including imaging when findings are concerning.