First there was GWAS (Genome-Wide Association Study). Now there's PheWAS.
So, what does one make of such associations that get thrown up? For an FM-sceptic (cynic even) like me, I wonder if many of the SNRA may simply be just FM.
Fibromyalgia exaggerates RA disease activity. Ultrasound paints a more accurate picture of the actual inflammatory burden. The treatment of FM differs significantly from that of inflammation. Ultrasound at the point of care is indispensable to guide appropriate and best care.
Fibromyalgia will inadvertently exaggerate disease activity assessments which use outcome measures more heavily weighted on patient reported outcomes (PRO), compared to those weighted towards more objective measures like physical examination and laboratory tests.
However, it is being increasingly demonstrated that PROs are more sensitive in detecting disease flares and inflammatory activity that matter: those which lead eventually to joint damage and disability.
The ideal balanced Disease Activity Indices in the rheumatic diseases remain a work in progress.
I'm sure rheumatologists the world over will welcome internists and primary care physicians with open arms to share in the care of patients with Fibromyalgia.