David - all good points. I personally pay no attention to ACR-EULAR criteria as they are for trials and not practice. I too have a problem with tender joints only in this definition and rely strongly on the presence of synovitis. Nevertheless, you can still only get 2 or 3 points as an FM patient with these joints tender - you need another 3 or more points from CCP/RF serologies or acute phase reactants. Thanks JJC