The following is a summary of “Vast Majority of Patients With Fibromyalgia Have a Straight Neck Observed on a Lateral View Radiograph of the Cervical Spine: An Aid in the Diagnosis of Fibromyalgia and a Possible Clue to the Etiology,” published in the March 2023 issue of Rheumatology by Katz, et al.
For a retrospective medical records review study, researchers sought to investigate the prevalence of cervical spine curvature abnormalities in fibromyalgia patients compared to control subjects. Specifically, the study aimed to assess the cervical curvature using the Cobb angle measurement on radiographs of patients with fibromyalgia.
They retrospectively analyzed 270 cervical spine radiographs of patients with neck pain from 2015 to 2018. Among them, 155 patients met the American College of Rheumatology criteria for fibromyalgia, while the remaining 115 subjects had other rheumatic diseases and were age- and education-matched controls. The cervical curvature was measured using the Cobb angle method.
In fibromyalgia, the mean cervical curvature was 6.4±5.2 degrees, compared to 13.8 ±7.4 degrees in control patients. The difference of more than 7 degrees was noteworthy (P< 0.001). About 21 degrees of curvature is at the low end of the typical range. There were 129 fibromyalgia patients (83.2%) and 37 control participants (32.2%) at an angle of ≤10 degrees when the cervical spine is practically straight. The difference of 51% (P< 0.001) was significant.
Most fibromyalgia patients have a similar anomaly that may be seen on a straightforward radiograph. The cervical spine was almost straight (Cobb angle ≤10 degrees) in 83.2% of the individuals. The decrease in cervical curvature was 50.3% higher in fibromyalgia patients compared to control persons (7.8% vs. 6.5%). A significant anatomical defect in fibromyalgia that has gone undiagnosed may be a straight neck without other radiographic abnormalities. Increased muscle tension or pressure may be a potential cause, which could help with the diagnosis.
