Purple words or phrases from the text pages are explained here...

Adsonís Sign

Paresthesias and loss of the radial pulse in the arm during abduction and external rotation at the shoulder. This may be augmented by turning the head to the same side. This may be a sign of Thoracic Outlet Syndrome, but is also very common in ME/CFS and FM.

Canadian Clinical Criteria


Digit Span

This is a test of attention and concentration.  The subject is asked to repeat a series of numbers read to him by the examiner. Test for retention of digits forward first. When the upper range is determined, test for retention of digits in reverse.  The digits should be spoken at one per second, and not grouped.  Stop after two failures in any given series. Less than 7 digits forward and 5 digits in reverse is abnormal; less than 5 digits forward and 3 digits in reverse is well below average. Significant difficulty on this test should trigger consideration of full neuropsychiatric testing.  

Suggested digit series:    518, 6501, 37514, 239715, 4391697.


Hypermobility of joints is common in ME/CFS (J Pediatr. 2002 Sep;141(3):421-5) and may be associated with orthostatic hypotension. For a brief summary see: http://www.hypermobility.org/whatishms.php

To learn how to diagnose this disorder see: http://www.hypermobility.org/beighton.php

A brief treatise on the subject can be found at: http://www.jaoa.org/cgi/content/full/106/9/531

International CFS Criteria


Myofascial bands

Myofascial (or taut) bands occur when muscle tension or spasm persists. Taut bands are common in persons with ME/CFS and FM, and may evolve into Myofascial Pain Syndrome with active trigger points if the tension is perpetuated. For more see: http://www.emedicine.com/pmr/topic84.htm

Orthostatic hypotension

Orthostatic intolerance is common in ME/CFS (J Auton Ner Syst 1999; 75:192-201, Am J Med 1997; 104: 957-964). Many patients exhibit delayed orthostatic hypotension; smaller subsets exhibit Postural Orthostatic Tachycardia Syndrome or POTS  (http://www.dinet.org/pots_an_overview.htm ) and Neurally Mediated Hypotension (JAMA 1995; 274:961-967, http://avoca.vicnet.net.au/~mecfs/general/nmh1.html ).

Phelanís Sign

Prolonged flexion of the wrist causes paresthesias of the lower forearm due to compression of the median nerve. This is a test for median neuropathy (carpal tunnel syndrome).

Serial 7 Subtraction

This is a test of concentration in which the subject is asked to serially subtract 7 from one hundred as rapidly and as audibly as possible.  The average time for completion is up to 90 seconds, and more than 4 errors is abnormal.  It is not a test of mathematical ability alone.  Before arithmetical errors are noted the subject may demonstrate hesitation or questioning, request a new start, or become upset or irritable. This should be noted. Abnormalities should trigger consideration of full neuropsychiatric testing.  


Tenderpoints are places on the body (18 specific points at 9 bilateral locations) that are exceptionally sensitive to palpation. Tenderpoints are unique to persons with fibromyalgia. See http://www.fibromyalgiasupport.com/fibromyalgia-tenderpoints.htm

Tinelís Sign

A tingling sensation felt in the distal portion of the forearm upon percussion of the skin over the dorsal wrist. Evidence of median neuropathy (carpal tunnel syndrome).

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