Internal Medicine

0521779407-07 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:10

568 Fibromas Fibromyalgia

Fibromas..........................................

SOL SILVERMAN JR, MD

history & physical

■common soft, sessile, pedunculated benign mucosal growths

■usually painless and slow growing

■mucosal response to acute or chronic irritation; often cause not iden-

tified

tests

■observe; usually self-limiting growth

■excisional biopsy

differential diagnosis

■benign tumors

management

■remove irritants (e.g. cheek biting, appliances); observe for growth

specific therapy

■surgical removal

follow-up

■observe for recurrence

complications and prognosis

■usually none

Fibromyalgia.......................................

DANIEL J. CLAUW, MD

history & physical

History

■Hallmark symptom: chronic widespread pain, above & below the

waist

■Pain may be migratory, waxing & waning in intensity

■May involve both peripheral & visceral structures

■60–80% females

■Associated symptoms

■Fatigue, non-restorative sleep, memory difficulties, headaches,

paresthesias, irritable bowel or bladder