I've read so many posts that indicate some think that FMS is a diagnosis of "last resort", and only given when everything is ruled out. Some believe that there is an underlying problem. Yes, FMS is diagnosed when after any other malady is ruled out, which means tests and more tests; however, it's not a "waste basket" diagnosis; it's as real as any other malady - I have lupus and FMS. Some symptoms are the same, and some aren't. For the most part, routine laboratory testing reveals nothing about fibromyalgia. However, upon physical examination by a rheumatologist, the person with FMS will be sensitive to pressure in certain areas of the body called tender points. To meet the diagnostic criteria for FMS, patients must have: A. Widespread pain in all four quadrants of their body for a minimum of three months B. At least 11 of the 18 specified tender points (to qualify for diagnosis) * Tender points are specific places on the body (18 specific points at 9 bilateral locations) that are exceptionally sensitive to the touch in people with fibromyalgia upon examination by a doctor. This was determined to be a criterion in the diagnosis of FMS by rheumatologist who found that there were a group of people who had a certain number of tender points in certain locations on their body. Fibromyalgia is a syndrome rather than a disease. <b>THAT DOESN’T MEAN THAT IT’S A "TRASH CAN" DIAGNOSIS.</b> Unlike a medical condition with a specific cause or causes and recognizable signs and symptoms, a "syndrome" is a collection of signs, symptoms, and medical problems that tend to occur together but are not related to a specific, identifiable cause. Areas of the tender points: Low Cervical Region: (front neck area) at anterior aspect of the interspaces between the transverse processes of C5-C7. Second Rib: (front chest area) at second costochondral junctions. Occiput: (back of the neck) at suboccipital muscle insertions. Trapezius Muscle: (back shoulder area) at midpoint of the upper border. Supraspinatus Muscle: (shoulder blade area) above the medial border of the scapular spine. Lateral Epicondyle: (elbow area) 2 cm distal to the lateral epicondyle. Gluteal: (rear end) at upper outer quadrant of the buttocks. Greater Trochanter: (rear hip) posterior to the greater trochanteric prominence. Knee: (knee area) at the medial fat pad proximal to the joint line.