What is your approach to differentiating tender spots (as in fibromyalgia) and enthesitis (as in axSpA)?   

The tender points in fibromyalgia are not limited to tendon insertion sites but are much more generalized, such as in the middle of the muscles of the neck, shoulders and back. Often tender points in fibromyalgia are found at the costochondral junction and at the lateral epicondyle or other tendons ...