INFLAMMATORY MUSCLE DISEASE Flashcards
INFLAMMATORY MUSCLE DISEASE
🌸 TYPES
⭐ POLYMYOSITIS
⭐ DERMATOMYOSITIS
⭐ JUVENILE DERMATOMYOSITIS
⭐ INCLUSION BODY MYOSITIS
⭐ IMMUNE MEDIATED NECROTISING MYOPATHY
⭐ CANCER ASSOCIATED MYOPATHY
⭐ ANTI-SYNTHETASE Syndrome
⭐ Amyopathic DERMATOMYOSITIS
PAINLESS
➕
PROGRESSIVE
➕
SYMMETRICAL
➕
LOWER LIMB PREDOMINANT
➕
PERSISTANT SUBACUTE PROXIMAL WEAKNESS
Inflammatory MYOPATHIES
Muscle Involvement in INFLAMMATORY MUSCLE DISEASE
- Pharyngeal
⬇️ - Esophageal
⬇️ - Neck Flexors
⬇️ - Respiratory Muscles
GOLD STANDARD INVESTIGATION FOR INFLAMMATORY MUSCLE DISEASE
Muscle BIOPSY
Investigation in INFLAMMATORY MUSCLE DISEASE
- Muscle Biopsy
- CPK ⬆️
- Aldolase B
- EMG
- MRI of Thigh Muscle
Age group: Juvenile DERMATOMYOSITIS
Age group: Adult onset DERMATOMYOSITIS
⭐ 5-15 yrs
⭐ 45-65 yrs
F:M in DERMATOMYOSITIS
2:1
Skin lesion in Dermatomyositis occurs by
6 months BEFORE Weakness
Weakness does not occur by 6 months of Skin lesions is known as
AMYOPATHIC DERMATOMYOSITIS
Acute PRESENTATION of DERMATOMYOSITIS
Pain and Weakness for Weeks to Months
In 30% pts
Difference between Gottron’s papules and Gottron’s Rash
Anything other than a papules in place of Gottron’s papules
Calcinosis Cutis seen in
- Systemic Sclerosis
- Juvenile DERMATOMYOSITIS
Pathognomic SIGNS in DERMATOMYOSITIS
- Gottron papules
- Heliotrope Rash
Signs seen in DERMATOMYOSITIS
Less-SPECIFIC
- Gottron’s sign
- Photo sensitivity
- V sign
- Shawl sign
- Holster sign
- Nail fold capillary changes with cuticular overgrowth
- Pruritic Scalp Involvement
- Mechanic Hand
- Calcinosis cutis
EMG in INFLAMMATORY MUSCLE DISEASE
⭐ Polyphasic Short Duration Small Amplitude Potentials
⭐ High frequency discharges
⭐ Spontaneous activity like fibrillation or Denervation
Classical FINDING in DERMATOMYOSITIS
Peri-vascular lymphocytic infiltrates
➕
Peri-Fasicular Atrophy
➕
No NECROSIS
In Juvenile DERMATOMYOSITIS always rule out
Malignancy of Ovary and Lung
DERMATOMYOSITIS like weakness ⛔ Skin lesion
➕
Late Presentation 50-60yrs
➕
Necrosis ➕ at BIOPSY (But NO ATROPHY)
POLYMYOSITIS
Antibodies seen in DERMATOMYOSITIS and POLYMYOSITIS
⭐ anti Jo1 (anti-synthetase)
Anti-Jo1 ➕ INCREASR THE RISK OF
(Anti-Synthetase)
- Mechanic’s HAND
- Interstitial LUNG Disease: NSIP
- Raynaud’s phenomena
- Arthritis: SLE-like
Which SKIN MANIFESTATION is seen in Both POLYMYOSITIS and DERMATOMYOSITIS
Mechanic’s Hand
Anti-Mi2
Seen in
DERMATOMYOSITIS without ILD
GOOD PROGNOSIS
Anti-SRP is ASSOCIATED with
Immune-mediated Necrotizing MYOPATHY
ASSOCIATED with statin use
Antibody that indicates
✨ RAPID SKIN Involvement
✨ ILD
Anti MDA5
Antibodies ASSOCIATED with
⭐ Cancer associated DERMATOMYOSITIS
⭐ Juvenile DERMATOMYOSITIS
Anti-TIF 1GAMMA
Anti-NxP2 (anti nuclear matrix protein 2)
