ExplanationThe rest of the answers are blatantly wrong. Secondary fibromyalgia may not be clinically distinguishable from that of primary fibromyalgia. Examples of secondary fibromyalgia: • Rheumatoid arthritis patients have fibromyalgia 30% of the time • Systemic lupus erythematosus (SLE) 40% • Sjögren syndrome 50% • Lyme disease 20%; the symptoms of fibromyalgia may develop 1 to 4 months after infection, often in association with Lyme arthritis. The signs of Lyme disease will normally resolve with antibiotics, but the fibromyalgia symptoms can persist • Chronic hepatitis • Inflammatory bowel disease • Tuberculosis • Chronic syphilis • Bacterial endocarditis • AIDS • Hypothyroidism • Hypopituitarism • Hemochromatosis Patients with rheumatic disease and concomitant fibromyalgia experience joint pain out of proportion to their synovitis. The practitioner should treat each of the conditions separately, because increasing the dosage of antirheumatic medications in the absence of active inflammation might have minimal effect on the pain augmented by the fibromyalgia.
