Diffuse pain syndromes

Question 1

What is chronic widespread pain?

Answer 1

This is pain for greater than 6 months in 2 or more locations above and below the pelvis

Question 2

What are the common associations with chronic widespread pain?

Answer 2

Patients often have multiple stressors in their life
Often associated with:
-IBD
-Headache syndromes
-Chronic fatigue syndromes

Question 3

What is fibromyalgia?

Answer 3

This is a disease of unknown pathology that is thought to be involved with altered pain perception and peripheral hyperexcitability

Question 4

WHAT IS INFLAMMATORY MYOSITIS?

Answer 4

Chronic inflammation of striated muscles

Question 5

what are the 4 subtypes of inflammatory myositis?

Answer 5

Polymyositis
Dermatomyositis
Mixed connective tissue disease
Associated with malignancy

Question 6

What is the typical presentation of inflammatory myositis?

Answer 6

It presents with pain, stiffness and tenderness in muslces. Proximal muscles are predominently affected.

Question 7

What investigations should be done for inflammatory myositis?

Answer 7

Creatine kinase monitors disease progression
anti-Jo-1 commonest antibody
80% of patients are ANA positive
Spirometry to monitor respiratory involvement

Question 8

What is the management of inflammatory myositis?

Answer 8

Corticosteroids are first line followed by immunosupressants such as cyclophosphamide